Individual
ALYSSA JORDAN ELLEGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
332 W SUPERIOR ST STE 300, DULUTH, MN 55802-1844
(218) 722-4379
(218) 722-4333
Mailing address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4261
MN
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/01/2018
Last updated
03/05/2024
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