Individual
ANDREA SUZANNE JAGUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(651) 326-7662
Mailing address
7023 49TH ST N, OAKDALE, MN 55128-2650
(507) 398-3603
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
19881
MN
1041S0200X
School Social Worker
Primary
465089
MN
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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