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Individual

MS. JENNIFER REBECCA GIFFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LADC

Contact information

Practice address
115 WILLOW ST W, SUITE #1, DETROIT LAKES, MN 56501-3922
(218) 844-5191
(218) 844-5193
Mailing address
115 WILLOW ST W, SUITE #1, DETROIT LAKES, MN 56501-3922
(218) 844-5191
(218) 844-5193

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302760
MN
101YP2500X
Professional Counselor
101YS0200X
School Counselor
436787
MN

Other

Enumeration date
11/21/2009
Last updated
12/03/2009
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