Jay Michael Albrecht, PH.D.

Individual provider Active NPI Athletic Trainer · Moorhead, MN

NPI 1336569748 · NPPES record last updated Apr 6, 2017

Key facts

NPI
1336569748
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
2419 (MN)
Practice address
1104 7TH Ave S
Minnesota State University Moorhead
Moorhead, MN 56563-0001
Phone
(218) 477-2864
NPI assigned
Apr 24, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2419MNMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2419 MN Yes
Health Educator 174H00000X 2419 MN

Addresses

Primary practice location

1104 7TH Ave S
Minnesota State University Moorhead
Moorhead, MN 56563-0001

Mailing address

6596 45TH Ave S
Fargo, ND 58104-3324
Phone (701) 371-8969

Other providers in Moorhead, MN

All providers in Moorhead, MN · Athletic Trainer in Minnesota

Sources for this page

Verify at the official NPI Registry.