Harrison, Jackie
Harrison, Jackie is an sole proprietor health care provider with primary practice located at 12708 Wayzata Blvd Suite 412, Minnetonka MN 55305-1916. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Harrison, Jackie can be contacted via phone (763) 443-4562.Contact Information
Primary practice address
12708 Wayzata Blvd Suite 412
Minnetonka MN 55305-1916
Phone: (763) 443-4562
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1796 | Minnesota |
Profile Details
| NPI number | 1902295306 |
|---|---|
| LBN Legal business name | Harrison, Jackie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 22nd, 2015 |
| Last updated | Jul 23rd, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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