Individual
MR. ANDREW SUDBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, LADC
Contact information
Practice address
101 18TH AVENUE NORTH, PRINCETON, MN 55371
(763) 389-5080
(763) 631-9117
Mailing address
1506 1ST STREET, PRINCETON, MN 55371
(763) 389-5080
(763) 631-9117
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302611
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302611
LADC
MN
Enumeration date
03/27/2012
Last updated
03/27/2012
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