Individual
JESSICA FANBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3833 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-2599
(763) 767-3350
(763) 747-0912
Mailing address
3833 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-2599
(763) 767-3350
(763) 747-0912
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18522
MN
Other
Enumeration date
11/16/2015
Last updated
11/16/2015
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