Individual
JAN JIRAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MALP
Contact information
Practice address
314 CLIFTON AVE STE 303, MINNEAPOLIS, MN 55403-3376
(952) 985-1097
Mailing address
314 CLIFTON AVE STE 303, MINNEAPOLIS, MN 55403-3376
(952) 985-1097
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP3585
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154319900
—
MN
Enumeration date
09/20/2006
Last updated
09/10/2007
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