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Individual

MS. JULIE ANN THEISEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
2351 3RD STREET NW, 201, NEW BRIGHTON, MN 55112
(612) 559-6250
Mailing address
2351 3RD STREET NW, 201, NEW BRIGHTON, MN 55112
(612) 559-6250

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303869
MN

Other

Enumeration date
09/08/2014
Last updated
09/08/2014
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