Individual
JENNICA WANHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
207 JEFFERSON BLVD, BIG LAKE, MN 55309-4667
(763) 367-6080
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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