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Individual

MS. ALLISON MICHELLE IMMEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
516 CEDAR AVE, MOOSE LAKE, MN 55767-8170
(763) 245-9698
Mailing address
516 CEDAR AVE, MOOSE LAKE, MN 55767-8170

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304936
MN
101YM0800X
Mental Health Counselor
Primary
2544
MN

Other

Enumeration date
08/24/2017
Last updated
10/14/2023
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