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Individual

KATIE JEANNE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LADC

Contact information

Practice address
2217 NICOLLET AVE, MINNEAPOLIS, MN 55404-3382
(612) 767-0319
(612) 870-3796
Mailing address
10450 GRAND OAKS TRL, WOODBURY, MN 55129-4241
(507) 381-8165
(612) 879-3796

Taxonomy

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

Other

Enumeration date
09/30/2021
Last updated
09/30/2021
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