Individual
JESSICA MARIE BACKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3460 WASHINGTON DR STE 110, EAGAN, MN 55122-4301
(651) 314-3502
Mailing address
3460 WASHINGTON DR STE 110, EAGAN, MN 55122-4301
(651) 314-3502
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303507
MN
101YM0800X
Mental Health Counselor
Primary
1035
MN
Other
Enumeration date
08/16/2015
Last updated
05/13/2024
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