Individual
AMY JACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 ELTON HILLS LN NW, ROCHESTER, MN 55901-3577
(507) 292-1006
Mailing address
406 RICHLAND AVE, SAINT CHARLES, MN 55972-1344
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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