Healthcare Provider Details

I. General information

NPI: 1326979725
Provider Name (Legal Business Name): JOCELYNNE MARIA WOLDEMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOCELYNNE FLEMING-SMITH

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5221 VIKING DR
BLOOMINGTON MN
55435-5317
US

IV. Provider business mailing address

2330 MANUELA DR
CHASKA MN
55318-1290
US

V. Phone/Fax

Practice location:
  • Phone: 651-502-2945
  • Fax: 612-230-5364
Mailing address:
  • Phone: 651-502-2945
  • Fax: 612-230-5364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: