Penwarden, Jeffry R

Penwarden, Jeffry R is an individual health care provider with primary practice located at 1540 Lake St S , Forest Lake MN 55025-2628. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Penwarden, Jeffry R can be contacted via phone (651) 464-7100.

Contact Information

Primary practice address
1540 Lake St S Forest Lake MN 55025-2628
Phone: (651) 464-7100
Fax: (651) 982-5515
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP2545 Minnesota

Profile Details

NPI number 1871544478
LBN Legal business name Penwarden, Jeffry R
Credentials PHD, LP
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Jul 8th, 2007 - about 19 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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