Individual
GRACIE TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
660 18TH ST, GRANITE FALLS, MN 56241-1044
(320) 564-4911
Mailing address
PO BOX 116, GRANITE FALLS, MN 56241-0116
(320) 564-4911
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302194
MN
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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