Individual
LORA JAECKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3411 S. ST. CROIX TRAIL, AFTON, MN 55001
(651) 795-9777
Mailing address
406 ROOSEVELT DR, DRESSER, WI 54009-9065
(715) 966-5372
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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