Individual
PARIS PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
1404 CENTRAL AVE NE, MINNEAPOLIS, MN 55413-1517
(612) 871-7567
Mailing address
1404 CENTRAL AVE NE, MINNEAPOLIS, MN 55413-1517
(612) 871-7567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306011
MN
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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