Individual
CARLYN BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25210 HAZELWOOD DR, NISSWA, MN 56468-2797
(763) 438-4619
Mailing address
25210 HAZELWOOD DR, NISSWA, MN 56468-2797
(763) 438-4619
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303742
MN
101YP2500X
Professional Counselor
Primary
CC01826
MN
Other
Enumeration date
02/24/2016
Last updated
01/09/2023
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