Individual
ALYSHA KVAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12918 63RD AVE N, MAPLE GROVE, MN 55369-6001
(763) 210-9966
Mailing address
7200 WILLOW DR, CORCORAN, MN 55340-9717
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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