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Individual

JODI M KAPLA MASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC MT(ASCP)

Contact information

Practice address
2110 EAGLE CREEK LN STE 400, WOODBURY, MN 55129-3209
(575) 779-4851
Mailing address
410 CAMINO MIRAMONTES, ESPANOLA, NM 87532-8052
(575) 779-4851

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1894
MN
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1894
MINNESOTA ACUPUNCTURE LICENSE
MN
01
20064
NCCAOM
01
986-55
WISCONSIN ACUPUNCTURE LICENSE
WI
Enumeration date
05/07/2009
Last updated
09/20/2019
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