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General NPI Number Information
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NPI Number | 1558983106
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Entity Type | Individual
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Provider Name | JACQUELINE ROSE JASKEN LAMFT
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Gender | Female
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Dates
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Enumeration Date | 05/16/2020
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Last Update Date | 05/16/2020
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Provider Practice Location Address
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Address Line | 6750 FRANCE AVE S STE 200
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City | EDINA
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State | MN
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Zip | 55435-1904
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Country | US
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Telephone | 952-200-9929
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Fax |
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Provider Business Mailing Address
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Address Line | 501 CARLSON PKWY APT 324
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City | MINNETONKA
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State | MN
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Zip | 55305-5907
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Country | US
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Telephone | 952-200-9929
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3977
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License Number State | MN
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