Individual
MITCHELL MARC TAVERNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPCC
Contact information
Practice address
4027 COUNTY ROAD 25, MINNEAPOLIS, MN 55416-2629
(612) 925-6033
(612) 925-8496
Mailing address
4240 PARK GLEN RD, ST LOUIS PARK, MN 55416-5427
(612) 925-6033
(612) 925-8496
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
948
MN
Other
Enumeration date
03/13/2015
Last updated
12/13/2023
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