Individual
KRISTINA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
762 TRANSFER RD STE 21, SAINT PAUL, MN 55114-1489
(763) 789-4895
(763) 789-4798
Mailing address
3606 55TH AVE N, BROOKLYN CENTER, MN 55429-3310
(612) 599-5471
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC01611
MN
Other
Enumeration date
07/26/2018
Last updated
03/27/2019
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