Individual
LEAH MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 W 64TH ST, RICHFIELD, MN 55423-1001
(612) 798-8356
(612) 798-5301
Mailing address
6335 LYNDALE AVE S APT 107, RICHFIELD, MN 55423-1463
(612) 798-8356
(612) 798-5301
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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