Individual
MRS. KATHY CLARK DANSBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
2738 WINNETKA AVE N # 150M2, NEW HOPE, MN 55427-2850
(763) 762-8728
(763) 762-8762
Mailing address
4425 RHODE ISLAND AVE N APT 324, NEW HOPE, MN 55428-4942
(763) 710-7207
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300889
MN
Other
Enumeration date
12/28/2018
Last updated
03/11/2019
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