Individual
JACOB KINNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAPC
Contact information
Practice address
2701 12TH AVE S, FARGO, ND 58103-8753
(701) 451-4900
(651) 925-0057
Mailing address
2701 12TH AVE S, FARGO, ND 58103-8753
(701) 451-4900
(651) 925-0057
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1373-7-1-24A
ND
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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