Individual
JENNA MARIE LEIRMOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPCC
Contact information
Practice address
38878 12TH AVE, NORTH BRANCH, MN 55056
(612) 406-4469
Mailing address
38878 12TH AVE, NORTH BRANCH, MN 55056-6658
(612) 406-4469
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC01824
MN
Other
Enumeration date
06/27/2018
Last updated
06/28/2019
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