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Individual

JAMIE LEE HENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW, LADC

Contact information

Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3118
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3118

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304057
MN
1041C0700X
Clinical Social Worker
18513
MN

Other

Enumeration date
12/05/2019
Last updated
12/05/2019
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