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General NPI Number Information
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NPI Number | 1043734122
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Entity Type | Individual
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Provider Name | JESSICA CHRISTINE SMITH LMFT
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Gender | Female
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Dates
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Enumeration Date | 07/31/2017
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 6542 REGENCY LN STE 213
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-7848
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Country | US
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Telephone | 952-214-1638
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Fax |
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Provider Business Mailing Address
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Address Line | 13240 FLAGSTAFF AVE
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City | APPLE VALLEY
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State | MN
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Zip | 55124-7938
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Country | US
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Telephone | 651-262-6152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3506
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License Number State | MN
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