Individual
JESSICA MAGARITE PUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LADC
Contact information
Practice address
5939 PORTLAND AVE, MINNEAPOLIS, MN 55417-3127
(612) 869-4444
Mailing address
5824 45TH AVE S, MINNEAPOLIS, MN 55417-3023
(612) 802-6902
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304454
MN
101YP2500X
Professional Counselor
Primary
2453
MN
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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