Individual
JAMIE HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
7580 160TH ST W, LAKEVILLE, MN 55044-8348
(952) 898-1133
Mailing address
6231 TAHOE PL, WOODBURY, MN 55125-1468
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
23490
MN
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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