Individual
RACHEL D WICKSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
332 W SUPERIOR ST, DULUTH, MN 55802-1808
(218) 722-4379
Mailing address
1624 GRAHAM LAKE RD, HOLYOKE, MN 55749-9519
(218) 391-2508
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300551
MN
Other
Enumeration date
05/15/2022
Last updated
05/15/2022
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