Individual
NICOLE MARIE BLANCHARD-VAN TASSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
343 WOODLAKE DR SE, ROCHESTER, MN 55904-6242
(507) 512-3512
Mailing address
29 7TH ST NE, ROCHESTER, MN 55906-3644
(507) 512-3512
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306310
MN
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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