Individual
MEGAN LAUREL BOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1821 UNIVERSITY AVE W STE N385, SAINT PAUL, MN 55104-2872
(612) 326-7596
Mailing address
1821 UNIVERSITY AVE W STE N385, SAINT PAUL, MN 55104-2872
(612) 326-7596
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304116
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205557491
—
MN
Enumeration date
01/03/2019
Last updated
01/03/2019
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