Micklewright, Jackie Lyn

Micklewright, Jackie Lyn is an individual health care provider with primary practice located at 280 Smith Ave N Ste 220 , Saint Paul MN 55102-2459. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Neuropsychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Micklewright, Jackie Lyn can be contacted via phone (651) 241-8295.

Contact Information

Primary practice address
280 Smith Ave N Ste 220 Saint Paul MN 55102-2459
Phone: (651) 241-8295
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP5324 Minnesota
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X

Profile Details

NPI number 1669705638
LBN Legal business name Micklewright, Jackie Lyn
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2009
Last updated Apr 28th, 2026 - about 7 months 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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Identifiers

StateTypeNumberIssuer
All States NPI 1669705638 NPPES
Minnesota Other 680003191 MEDICARE PTAN

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