Zaczkowski, Jeanette L

Zaczkowski, Jeanette L is an individual health care provider with primary practice located at 1811 Weir Drive Suite 355 Mail Stop 13701A, Woodbury MN 55125-2273. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Zaczkowski, Jeanette L can be contacted via phone (651) 730-6151.

Contact Information

Primary practice address
1811 Weir Drive Suite 355 Mail Stop 13701A Woodbury MN 55125-2273
Phone: (651) 730-6151
Fax: (651) 730-1700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 13080 Minnesota

Profile Details

NPI number 1942275235
LBN Legal business name Zaczkowski, Jeanette L
Credentials MSW LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Nov 4th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942275235 NPPES
Minnesota MEDICAID 924609600

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