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General NPI Number Information
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NPI Number | 1679752067
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Entity Type | Individual
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Provider Name | KARRIE ANN JENNINGS MA, LMFT, CEAP
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Gender | Female
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 23175 WOODLAND RD
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City | LAKEVILLE
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State | MN
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Zip | 55044-8264
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Country | US
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Telephone | 952-469-4159
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Fax |
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Provider Business Mailing Address
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Address Line | 23175 WOODLAND RD
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City | LAKEVILLE
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State | MN
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Zip | 55044-8264
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Country | US
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Telephone | 952-469-4159
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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 | 0911
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License Number State | MN
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