Anderson, Jack David

Anderson, Jack David is an individual health care provider with primary practice located at 10900 89Th Ave N Ste 3 , Maple Grove MN 55369-4025. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Anderson, Jack David can be contacted via phone (651) 560-0050.

Contact Information

Primary practice address
10900 89Th Ave N Ste 3 Maple Grove MN 55369-4025
Phone: (651) 560-0050
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1023712882
LBN Legal business name Anderson, Jack David
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2023
Last updated Mar 27th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers