Individual
JACLYN MAE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
9100 93RD AVE N, BROOKLYN PARK, MN 55445-1407
(763) 710-6133
Mailing address
8390 MISSISSIPPI BLVD NW, COON RAPIDS, MN 55433-5938
(763) 710-6133
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4447
MN
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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