Individual
JACQUELINE PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 W 50TH ST STE 250B, MINNEAPOLIS, MN 55410-2070
(612) 400-9685
Mailing address
3165 COUNTRYSIDE AVE UNIT F, SAINT PAUL, MN 55129-7833
(704) 451-8011
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4397
MN
Other
Enumeration date
09/17/2019
Last updated
05/30/2024
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