Individual
JACQUELINE MARIE JENNISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADC-T
Contact information
Practice address
1003 CLOQUET AVE STE 117, CLOQUET, MN 55720-1649
(218) 879-5545
Mailing address
2101 WOODDALE DR STE B, WOODBURY, MN 55125-4442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3126
MN
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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