Individual
JACQUELYN KAYE HANSON-HIETALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
205 W 2ND ST STE 300, DULUTH, MN 55802-1928
(218) 590-1178
(218) 481-7405
Mailing address
5380 SHADY LN, DULUTH, MN 55811-9732
(218) 590-1178
(218) 481-7405
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
26768
MN
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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