Individual
MS. JENNA L KAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
305 30TH AVE W, ALEXANDRIA, MN 56308-3429
(320) 460-8028
Mailing address
516 N SHORE DR APT 3, BATTLE LAKE, MN 56515-4070
(701) 261-7911
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305726
MN
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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