Individual
JENNIFER LEIGH VLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1875 STATION PKWY NW, ANDOVER, MN 55304-3319
(763) 482-9598
(612) 235-6447
Mailing address
1875 STATION PKWY NW, ANDOVER, MN 55304-3319
(763) 482-9598
(612) 235-6447
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12459
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255455100
—
MN
Enumeration date
03/09/2006
Last updated
11/22/2024
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