| Doctor Name: | JACQUELINE MARIE HARTH |
| NPI Number: | 1336380997 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LP |
| License Number: | LP5040 |
| Business Practice Address: | 415 Blake Rd N Ste 240 Hopkins, MN - 553438192 |
| Business Phone Number: | 9528140207 |
| Business Fax Number: | 9529388838 |
| Mailing Address: | 415 Blake Rd N Ste 240, HOPKINS |
| State: | MN |
| Postal Code: | 553438192 |
| Phone Number: | 9528140207 |
| Fax Number: | 9529388838 |
| NPI Enumeration Date: | 03/11/2009 |
| NPI Last Update Date: | 03/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | LP5040 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |