Individual
JEAN GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2233 HAMLINE AVE N STE 435, ROSEVILLE, MN 55113-5023
(651) 216-1935
Mailing address
2233 HAMLINE AVE N STE 435, ROSEVILLE, MN 55113-5023
(651) 216-1935
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
07664
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
439757600
—
MN
Enumeration date
09/20/2006
Last updated
07/21/2022
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