Individual
MS. TRISTA M GOTTWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LADC
Contact information
Practice address
2104 NORTHDALE BLVD NW STE 220, COON RAPIDS, MN 55433-3046
(763) 537-6000
Mailing address
2104 NORTHDALE BLVD NW STE 220, COON RAPIDS, MN 55433-3046
(763) 537-6000
(763) 537-6666
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
306045
MN
101YM0800X
Mental Health Counselor
Primary
4115
MN
Other
Enumeration date
06/09/2021
Last updated
11/19/2025
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