Jake Tastad

NPI #1346088200 in Shakopee, Minnesota

Provider Information

NPI Number: 1346088200
Entity Type: Individual
Name: Jake Tastad
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Jul 16, 2024
Last Updated: Jul 25, 2024

Practice Location

Address: 100 FULLER ST S
City: Shakopee
State: Minnesota
ZIP Code: 55379-1348
Phone: (888) 953-4955

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

Additional Practice Locations

9382 Oak Ave

Waconia, MN, 55387-9422

(855) 454-2463

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