Mallory Lagraves, Jaime-Lynn

Mallory Lagraves, Jaime-Lynn is an individual health care provider with primary practice located at 40 11Th St , Cloquet MN 55720-1817. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Mallory Lagraves, Jaime-Lynn can be contacted via phone (218) 879-4559.

Contact Information

Primary practice address
40 11Th St Cloquet MN 55720-1817
Phone: (218) 879-4559
Fax: (218) 879-0282
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1274 Minnesota

Profile Details

NPI number 1568918126
LBN Legal business name Mallory Lagraves, Jaime-Lynn
Credentials MSED, LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2016
Last updated Sep 23rd, 2021 - about 3 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

Identifiers

StateTypeNumberIssuer
All States NPI 1568918126 NPPES
Wisconsin MEDICAID 1568918126
Wisconsin MEDICAID 1568918126

Popular Providers