Individual
BIANCA LEE BODINE-HAAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1409 WILLOW ST STE 400, MINNEAPOLIS, MN 55403-3251
(612) 445-0225
(612) 445-0112
Mailing address
585 CLEVELAND AVE S, SAINT PAUL, MN 55116-1237
(612) 615-3221
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305716
MN
101YM0800X
Mental Health Counselor
Primary
CC03877
MN
Other
Enumeration date
11/15/2021
Last updated
08/25/2023
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