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1902295306
JACKIE HARRISON
MINNETONKA, MN
NPI
1902295306
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 1796)
Enumeration Date
2015-01-22
Last Update Date
2015-07-23
Business Address
-- JACKIE HARRISON
12708 WAYZATA BLVD SUITE 412
MINNETONKA, MN 55305-1916
Phone number: 763-443-4562
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Mailing Address
-- JACKIE HARRISON
12708 WAYZATA BLVD SUITE 412
MINNETONKA, MN 55305-1916
Phone number: 763-443-4562
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