Individual
JACLYN AMYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCC
Contact information
Practice address
111 HUNDERTMARK RD STE 450, CHASKA, MN 55318-1460
(952) 368-0450
Mailing address
1704 HICKORY HILL DR, EAGAN, MN 55122-2410
(218) 393-1328
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC02157
MN
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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