Individual
MRS. JAMIE JANE LICHY HALVORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
5540 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429-3069
(763) 780-3036
Mailing address
5540 BROOKLYN BLVD, BROOKLYN CENTER, MN 55429-3069
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2872
MN
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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