Individual
JACQUELINE RUTH SMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LADC
Contact information
Practice address
1800 CHICAGO AVE STE 200, MINNEAPOLIS, MN 55404-2592
(612) 695-4885
Mailing address
1800 CHICAGO AVE STE 200, MINNEAPOLIS, MN 55404-2592
(651) 485-8845
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC02558
MN
Other
Enumeration date
09/03/2020
Last updated
10/28/2024
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