Schupp, Anna Jelbert Bogestad

Schupp, Anna Jelbert Bogestad is an individual health care provider with primary practice located at 12301 Whitewater Dr Ste 101, Minnetonka MN 55343-9447. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Schupp, Anna Jelbert Bogestad can be contacted via phone (952) 999-6097.

Contact Information

Primary practice address
12301 Whitewater Dr Ste 101 Minnetonka MN 55343-9447
Phone: (952) 999-6097
Fax: (952) 426-0508
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP5293 Minnesota

Profile Details

NPI number 1548444292
LBN Legal business name Schupp, Anna Jelbert Bogestad
Credentials PSY.D., LP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2007
Last updated Dec 23rd, 2016 - about 10 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 1548444292 NPPES
Minnesota MEDICAID 1548444292

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