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Individual

JULIE BLASKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA LADC LMFT

Contact information

Practice address
1310 HWY 96 E, SUITE 200, WHITE BEAR LAKE, MN 55110
(612) 241-6004
Mailing address
3515 TIFFANY LANE, SHOREVIEW, MN 55126
(651) 238-2840

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303395
MN
106H00000X
Marriage & Family Therapist
Primary
3106
MN

Other

Enumeration date
02/03/2016
Last updated
07/21/2022
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