Provider Demographics
NPI:1609335157
Name:BIGLOW, JENNIFER FRANCES
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:FRANCES
Last Name:BIGLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 WILLSON RD STE 290
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-1346
Mailing Address - Country:US
Mailing Address - Phone:952-451-3161
Mailing Address - Fax:952-236-7129
Practice Address - Street 1:5200 WILLSON RD STE 290
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424-1346
Practice Address - Country:US
Practice Address - Phone:952-451-3161
Practice Address - Fax:952-236-7129
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3343106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3343OtherTHERAPY