Dr. Jackie Engebretson
Clinical Child & Adolescent Psychologist
3850 Park Nicollet Blvd
St Louis Park
, Minnesota 55416-2527
Dr. Jackie Engebretson
Clinical Child & Adolescent Psychologist
3850 Park Nicollet Blvd
St Louis Park
, Minnesota 55416-2527
(765) 609-0888
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Dr. Jackie Engebretson
- 17833 Cobblestone Way
- Eden Prairie, MN
- Zip : 55347-2139
- Phone : (765) 609-0888
Second Address
- Dr. Jackie Engebretson
- 3850 Park Nicollet Blvd
- St Louis Park, MN
- Zip : 55416-2527
- Phone : (952) 993-1000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist | LP5917 | MN |
National Provider Identifier
| NPI | 1134598667 |
|---|---|
| Provider Name | Dr. Jackie Engebretson |
| First Address | Eden Prairie, MN 55347-2139 |
| Second Address | St Louis Park, MN 55416-2527 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/09/2015 |
| Last Update Date | 15/09/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.