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Individual

LINDA BONGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
909 BROADWAY, ALEXANDRIA, MN 56308-2793
(320) 763-0124
Mailing address
PO BOX 173, BELGRADE, MN 56312-0173
(320) 441-9954

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304096
MN

Other

Enumeration date
02/05/2015
Last updated
02/05/2015
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