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NPI Code Detail

MEDICARE: KIMBERLY JEAN DEJNO LADC, LMFT

MEDICARE:   KIMBERLY JEAN DEJNO  LADC, 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
1101YA0400XAddiction (Substance Use Disorder) Counselor303922MN
2106H00000XMarriage & Family Therapist3329MN

General Provider Information

NPI Number : 1265948186
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY JEAN DEJNO LADC, LMFT
Provider Business Mailing Address
First Line : 3257 19TH ST NW STE 4
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-6797
Country : US
Telephone Number : 651-955-4633
Fax Number : 651-440-9827
Provider Business Practice Location Address
First Line : 3257 19TH ST NW STE 4
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-6797
Country : US
Telephone Number : 651-955-4633
Fax Number : 651-440-9827
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2017
Last Update Date : 03/04/2026

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Directions to “ KIMBERLY JEAN DEJNO LADC, LMFT” Practice Location

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