Individual
MS. TAYLOR KRISTINE VACCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BS
Contact information
Practice address
10729 TOWN SQUARE DR NE STE 120, BLAINE, MN 55449-7923
(763) 343-9010
(763) 343-9011
Mailing address
10729 TOWN SQUARE DR NE STE 120, BLAINE, MN 55449-7923
(763) 343-9010
(763) 343-9011
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2021
Last updated
09/09/2022
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