Individual
JACQUELINE MARY WRUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
713 ANDERSON AVE, SAINT CLOUD, MN 56303-2048
(320) 229-3760
(320) 229-3762
Mailing address
713 ANDERSON AVE, SAINT CLOUD, MN 56303-2048
(320) 229-3760
(320) 229-3762
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305256
MN
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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