Individual
MS. ANNE MARIE ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCC, LADC
Contact information
Practice address
823 MAPLE ST, BRAINERD, MN 56401-3770
(320) 232-5402
Mailing address
823 MAPLE ST, BRAINERD, MN 56401-3770
(320) 232-5402
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303339
MN
101YM0800X
Mental Health Counselor
Primary
01866
MN
Other
Enumeration date
07/29/2018
Last updated
01/14/2019
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