Individual
JESSICA KOEP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LGSW, LADC
Contact information
Practice address
595 SELBY AVE, SAINT PAUL, MN 55102-1730
(214) 403-5052
Mailing address
1986 LEE ST, MAPLEWOOD, MN 55117-2231
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24858
MN
Other
Enumeration date
07/23/2017
Last updated
07/23/2017
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