Individual
MRS. CHRISTINE MARIE BANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
310 MONTANA AVE, MORRIS, MN 56267-1434
(320) 288-9138
Mailing address
310 MONTANA AVE, MORRIS, MN 56267-1434
(320) 288-9138
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302328
MN
Other
Enumeration date
03/22/2007
Last updated
11/25/2019
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