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General NPI Number Information
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NPI Number | 1225183981
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Entity Type | Organization
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Legal Business Name | CJA CONSULTING, INC.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 106 8TH AVE SE SUITE 200
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City | BAUDETTE
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State | MN
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Zip | 56623
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Country | US
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Telephone | 218-634-1499
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Fax | 218-634-4520
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Provider Business Mailing Address
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Address Line | 108 8TH AVE SE SUITE 200
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City | BAUDETTE
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State | MN
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Zip | 56623
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Country | US
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Telephone | 218-634-1499
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Fax | 218-634-4520
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Authorized Official
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Title or Position | PRESIDENT
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Name | CONSTANCE ANDERSON AAGARD
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Credential | MSED, LP
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Telephone | 218-634-1499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP0390
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License Number State | MN
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