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Individual

JADA DELACRUZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
1826 COMMERCE DR, NORTH MANKATO, MN 56003-1800
(507) 229-0350
(507) 216-0371
Mailing address
1826 COMMERCE DR, NORTH MANKATO, MN 56003-1800
(507) 229-0350
(507) 216-0371

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2754
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
306648
LADC LICENSE
MN
Enumeration date
05/09/2022
Last updated
09/07/2023
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