Individual
MR. JACOB CHARLES LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(218) 839-3572
Mailing address
2323 VICTORIA ST N, ROSEVILLE, MN 55113-4444
(218) 839-3572
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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