Individual
MAKENNA NOSBUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
6726 WALKER STREET, ST. LOUIS PARK, MN 55426
(612) 444-1520
(612) 416-3151
Mailing address
1692 ROSEWOOD AVE S, MAPLEWOOD, MN 55109-3633
(763) 438-6074
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
02263
MN
Other
Enumeration date
12/26/2016
Last updated
03/13/2024
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