Individual
AMANDA ROSE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5430 BOONE AVE N, NEW HOPE, MN 55428-3615
(763) 592-2600
Mailing address
14856 RIVER XING, SAVAGE, MN 55378-2967
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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