Healthcare Provider Details

I. General information

NPI: 1962784462
Provider Name (Legal Business Name): JENNIFER D. J, HOBBS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 ENERGY PARK DR 340
SAINT PAUL MN
55108-5276
US

IV. Provider business mailing address

1360 ENERGY PARK DR 340
SAINT PAUL MN
55108-5276
US

V. Phone/Fax

Practice location:
  • Phone: 651-646-8985
  • Fax:
Mailing address:
  • Phone: 651-646-8985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: