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Individual

MRS. STACY MARIE KRIESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LADC, LPCC

Contact information

Practice address
703 THIELEN DR, SAINT MICHAEL, MN 55376-9613
(763) 515-4563
Mailing address
6377 85TH ST NE, FOLEY, MN 56329-9540
(320) 266-3819
(763) 389-5453

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302909
MN
101YP2500X
Professional Counselor
Primary
MN

Other

Enumeration date
04/03/2012
Last updated
07/24/2019
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