Provider Demographics
NPI:1063652550
Name:SCZEPANSKI PALKERT, JANA MARIE (LMFT)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:MARIE
Last Name:SCZEPANSKI PALKERT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7298 WESTON LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-2540
Mailing Address - Country:US
Mailing Address - Phone:612-281-4870
Mailing Address - Fax:
Practice Address - Street 1:7298 WESTON LN N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55311-2540
Practice Address - Country:US
Practice Address - Phone:612-281-4870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1951106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist