Provider Demographics
NPI:1508011834
Name:HABER, JENNIFER KIM (MSPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KIM
Last Name:HABER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 CHICAGO AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1353
Mailing Address - Country:US
Mailing Address - Phone:612-863-4446
Mailing Address - Fax:612-863-5698
Practice Address - Street 1:2800 CHICAGO AVE STE 102
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1318
Practice Address - Country:US
Practice Address - Phone:612-863-4446
Practice Address - Fax:612-863-5698
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN69902251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic