Healthcare Provider Details

I. General information

NPI: 1174166318
Provider Name (Legal Business Name): JANEL MARIE PITZEN SLOWINSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANEL MARIE PITZEN

II. Dates (important events)

Enumeration Date: 10/21/2019
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14050 NICOLLET AVE STE 301
BURNSVILLE MN
55337-5739
US

IV. Provider business mailing address

CO LAKE REGION HUMAN SERVICE CENTER 200 HWY 2 W
DEVILS LAKE ND
58301
US

V. Phone/Fax

Practice location:
  • Phone: 651-313-8080
  • Fax: 651-925-0610
Mailing address:
  • Phone: 701-665-2200
  • Fax: 701-665-2300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29931
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: