Jaclyn Rose Suchy
Counselor, Professional in Shoreview, MN. Individual provider (NPI-1).
NPI number1114717543
StatusActive
Last updated in NPPESMay 8, 2025
Details
- NPI
- 1114717543
- Entity type
- Individual (NPI-1)
- Name
- Jaclyn Rose Suchy
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 8, 2025
- Certification date
- May 8, 2025
- Last updated
- May 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 4950 | MN | Yes |
Practice location
3490 Lexington Ave N Ste 205Shoreview, MN 55126-8044
Phone 651-486-3808
Mailing address
240 Robert DrHastings, MN 55033-8807
Phone 651-428-4423
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