Individual
JACK WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
199 COON RAPIDS BLVD NW, SUITE 210, COON RAPIDS, MN 55433-5831
(612) 615-2788
Mailing address
199 COON RAPIDS BLVD NW, SUITE 210, COON RAPIDS, MN 55433-5831
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
02/26/2016
Last updated
02/26/2016
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