Individual
KRISTEN MARIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
16180 HASTINGS AVE SE STE 205, PRIOR LAKE, MN 55372-9228
(952) 443-4600
(952) 443-4604
Mailing address
PO BOX 51, VICTORIA, MN 55386-0051
(952) 443-4600
(952) 443-4604
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC02553
MN
Other
Enumeration date
04/12/2021
Last updated
05/28/2021
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