Provider Demographics
NPI:1396013355
Name:MILLER, JENNIFER RAE HOGLUND (LAMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RAE HOGLUND
Last Name:MILLER
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:RAE
Other - Last Name:HOGLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2040 WOODWINDS DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2522
Mailing Address - Country:US
Mailing Address - Phone:651-341-7714
Mailing Address - Fax:651-259-9750
Practice Address - Street 1:2040 WOODWINDS DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2522
Practice Address - Country:US
Practice Address - Phone:651-259-9753
Practice Address - Fax:651-259-9750
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health