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Individual

MS. MALLORY LYNN JACOBSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LICSW

Contact information

Practice address
9400 ZANE AVE N, BROOKLYN PARK, MN 55443-1814
(763) 762-6872
(763) 315-3539
Mailing address
9400 ZANE AVE N, BROOKLYN PARK, MN 55443-1814
(763) 762-6872
(633) 153-5397

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
28118
MN

Other

Enumeration date
07/30/2014
Last updated
07/08/2024
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