MEDICARE: JANA MARIE SCZEPANSKI PALKERT LMFT

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
1	106H00000X	Marriage & Family Therapist	1951	MN

General Provider Information

NPI Number	:	1063652550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA MARIE SCZEPANSKI PALKERT LMFT

Provider Business Mailing Address
First Line	:	7298 WESTON LN N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-2540
Country	:	US
Telephone Number	:	612-281-4870
Fax Number	:

Provider Business Practice Location Address
First Line	:	7298 WESTON LN N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-2540
Country	:	US
Telephone Number	:	612-281-4870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2009
Last Update Date	:	02/24/2009

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