Jackson, Regina Louise

Jackson, Regina Louise is an individual health care provider with primary practice located at 2616 Nicollet Ave , Minneapolis MN 55408-1628. 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. Jackson, Regina Louise can be contacted via phone (612) 871-7878.

Contact Information

Primary practice address
2616 Nicollet Ave Minneapolis MN 55408-1628
Phone: (612) 871-7878
Fax: (612) 871-2567
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 301404 Minnesota

Profile Details

NPI number 1649460478
LBN Legal business name Jackson, Regina Louise
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2007
Last updated Jul 27th, 2007 - about 19 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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