Individual
JESSICA ANN BAKKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC, LICSW
Contact information
Practice address
13503 EVELETH WAY, APPLE VALLEY, MN 55124-5706
(507) 318-9806
Mailing address
13503 EVELETH WAY, APPLE VALLEY, MN 55124-5706
(507) 318-9806
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302693
MN
1041C0700X
Clinical Social Worker
25353
MN
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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