Individual
RAVEN INDIGO WINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC, CCTP
Contact information
Practice address
21395 JOHN MILLESS DR STE 400, ROGERS, MN 55374-4407
(763) 424-1888
(763) 424-7288
Mailing address
2205 MEADOW OAK AVE APT 241, MONTICELLO, MN 55362-2612
(637) 639-9801
(763) 657-0819
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1759
MN
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
11/21/2014
Last updated
10/14/2021
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