Individual
DR. JACK KASL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1790 11TH ST SE, FOREST LAKE, MN 55025-1968
(612) 867-8451
(763) 552-0787
Mailing address
3095 NORWAY CIR S, CAMBRIDGE, MN 55008-2670
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1955
MN
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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