Individual
MR. MARK ANDRE DUPONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LP LADC
Contact information
Practice address
3001 SANFORD PKWY, THIEF RIVER FALLS, MN 56701-2700
(218) 681-4747
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9419
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
301178
MN
103T00000X
Psychologist
Primary
LP1455
MN
Other
Enumeration date
03/22/2007
Last updated
05/18/2024
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