Provider Demographics
NPI:1639375421
Name:POHL, JENNIFER LEIGH (LP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LEIGH
Last Name:POHL
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:310 E 38TH ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1300
Mailing Address - Country:US
Mailing Address - Phone:612-238-2395
Mailing Address - Fax:612-813-0786
Practice Address - Street 1:310 E 38TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1300
Practice Address - Country:US
Practice Address - Phone:612-238-2395
Practice Address - Fax:612-813-0786
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNLP4777103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical