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Individual

REGINA ANNE MUSTAFA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
604 5TH ST SW, ROCHESTER, MN 55902-3256
(507) 357-1742
Mailing address
5246 KING ARTHUR DR NW, ROCHESTER, MN 55901-2198
(612) 986-7724

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305862
MN

Other

Enumeration date
06/10/2021
Last updated
06/10/2021
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