Individual
JACLYN RACHELLE RICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433-2638
(763) 767-3350
(763) 767-0912
Mailing address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/29/2018
Last updated
07/22/2019
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