Individual provider · Type 1 NPI

Jackie Harrison

Addiction (Substance Use Disorder) Counselor · Minnetonka, MN

NPI number 1902295306 Active

Practice location

12708 Wayzata Blvd, Suite 412
Minnetonka, MN 55305-1916

Call (763) 443-4562 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X1796 (MN)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1902295306

Jackie Harrison's National Provider Identifier is 1902295306, issued on Jan 22, 2015. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Minnetonka, MN. The record was last updated on Jul 23, 2015.