Individual
JESSICA LYNN BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3030 CENTRE POINTE DR # 90, ROSEVILLE, MN 55113-1112
(651) 461-2022
Mailing address
211 DEER PATH, STILLWATER, MN 55082-5384
(715) 797-8902
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1007140
WI
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
06/17/2022
Last updated
04/07/2025
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