Individual
MRS. TASHINA LERAE BRANCHAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW, LADC, CADCII
Contact information
Practice address
1705 ANNE ST NW, BEMIDJI, MN 56601-6151
(218) 333-2035
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(218) 368-2472
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306023
MN
Other
Enumeration date
04/12/2022
Last updated
06/21/2024
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