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NPI Code Detail

MEDICARE: JILL DIANE BOIKE LICSW

MEDICARE: JILL DIANE BOIKE LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker15207MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386702561
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL DIANE BOIKE LICSW
Provider Business Mailing Address
First Line : 5200 WILLSON RD STE 150
Second Line :
City : EDINA
State : MN
Zip : 55424-1300
Country : US
Telephone Number : 763-270-0054
Fax Number : 763-208-6371
Provider Business Practice Location Address
First Line : 5200 WILLSON RD STE 150
Second Line :
City : EDINA
State : MN
Zip : 55424-1300
Country : US
Telephone Number : 763-270-0054
Fax Number : 763-208-6371
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2006
Last Update Date : 12/10/2025

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Directions to “ JILL DIANE BOIKE LICSW” Practice Location

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