Individual
JESSICA HARGREAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16180 HASTINGS AVE SE, PRIOR LAKE, MN 55372-9227
(952) 443-4600
Mailing address
2013 PORTLAND AVE, MINNEAPOLIS, MN 55404-4563
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/12/2018
Last updated
08/19/2021
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