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1649460478
REGINA LOUISE JACKSON
MINNEAPOLIS, MN
NPI
1649460478
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 301404)
Enumeration Date
2007-07-27
Last Update Date
2007-07-27
Business Address
-- REGINA LOUISE JACKSON
2616 NICOLLET AVE
MINNEAPOLIS, MN 55408-1628
Phone number: 612-871-7878
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Mailing Address
-- REGINA LOUISE JACKSON
2616 NICOLLET AVE
MINNEAPOLIS, MN 55408-1628
Phone number: 612-871-7878
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