Provider Demographics
NPI:1790053460
Name:SOLIN, JENNIFER JEAN (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JEAN
Last Name:SOLIN
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:JEAN SOLIN
Other - Last Name:ROTHSCHADL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD, LP
Mailing Address - Street 1:4660 SLATER RD
Mailing Address - Street 2:SUITE 245C
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-4047
Mailing Address - Country:US
Mailing Address - Phone:651-757-7430
Mailing Address - Fax:
Practice Address - Street 1:8550 HUDSON BLVD N
Practice Address - Street 2:
Practice Address - City:LAKE ELMO
Practice Address - State:MN
Practice Address - Zip Code:55042
Practice Address - Country:US
Practice Address - Phone:651-254-8580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5907103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical