Individual
COLLEEN MACKAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1215 SE 7TH AVE, GRAND RAPIDS, MN 55744-4201
(218) 313-1315
Mailing address
1215 SE 7TH AVE, GRAND RAPIDS, MN 55744-4201
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300382 (LADC)
MN
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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