Individual
JEANNETTE ANNA-MARIE VICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3525 MONTEREY DR, ST LOUIS PARK, MN 55416-5275
(952) 993-6200
(952) 993-5599
Mailing address
3525 MONTEREY DR, ST LOUIS PARK, MN 55416-5275
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2615
MN
Other
Enumeration date
07/29/2013
Last updated
07/29/2013
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