Individual
JENNIFER ANN MALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3263 XENIA AVE N, CRYSTAL, MN 55422-2637
(701) 238-6862
Mailing address
3263 XENIA AVE N, CRYSTAL, MN 55422-2637
(701) 238-6862
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC00391
MN
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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