Individual
MS. COLLEEN J NIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, LADC
Contact information
Practice address
1825 CURVE CREST BLVD W, STILLWATER, MN 55082-5090
(612) 351-8375
Mailing address
1825 CURVE CREST BLVD W, STILLWATER, MN 55082-5090
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302846
MN
Other
Enumeration date
04/08/2011
Last updated
12/28/2011
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