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NPI Code Detail

MEDICARE: JESSICA GRAD

MEDICARE:   JESSICA  GRAD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor5410MN

General Provider Information

NPI Number : 1790636272
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA GRAD
Provider Business Mailing Address
First Line : 708 N 1ST ST STE 234
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55401-1145
Country : US
Telephone Number : 612-741-6863
Fax Number :
Provider Business Practice Location Address
First Line : 708 N 1ST ST STE 234
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55401-1145
Country : US
Telephone Number : 612-741-6863
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “ JESSICA GRAD ” Practice Location

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