Bach Gansen, Loretta Jayne

Bach Gansen, Loretta Jayne is an individual health care provider with primary practice located at 515 Bridge St , Park Rapids MN 56470-1210. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Bach Gansen, Loretta Jayne can be contacted via phone (218) 366-9229.

Contact Information

Primary practice address
515 Bridge St Park Rapids MN 56470-1210
Phone: (218) 366-9229
Fax: (218) 237-2520
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 300392 Minnesota

Profile Details

NPI number 1164656989
LBN Legal business name Bach Gansen, Loretta Jayne
Credentials L.A.D.C.
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2009
Last updated Feb 20th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164656989 NPPES
Minnesota Other 1164656989 LADC

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