Provider Demographics
NPI:1336803840
Name:DORSCHNER, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:DORSCHNER
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 1:2061 SHEPARD RD APT 305
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-3238
Mailing Address - Country:US
Mailing Address - Phone:651-354-2835
Mailing Address - Fax:
Practice Address - Street 1:7505 METRO BLVD
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-3081
Practice Address - Country:US
Practice Address - Phone:651-271-1665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-30
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN282261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical