Provider Demographics
NPI:1932437126
Name:JAMISON, JORJA (MS)
Entity Type:Individual
Prefix:
First Name:JORJA
Middle Name:
Last Name:JAMISON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JORJA
Other - Middle Name:JAMISON
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5100 6TH ST NE
Mailing Address - Street 2:APT 33
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-1669
Mailing Address - Country:US
Mailing Address - Phone:952-454-2396
Mailing Address - Fax:
Practice Address - Street 1:1068 LAKE ST S
Practice Address - Street 2:STE 109
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2633
Practice Address - Country:US
Practice Address - Phone:651-982-4792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health