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Individual

CHEYNE SUMMER PAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8060 HWY 55 # 100, ROCKFORD, MN 55373-9407
(612) 477-6857
Mailing address
1124 MANITOU ST, BIG LAKE, MN 55309-9594

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
306873
MN
101YM0800X
Mental Health Counselor
Primary
5132
MN

Other

Enumeration date
08/05/2025
Last updated
08/05/2025
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