Individual
SHIRLEY CHRISTINE ZUPETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1137 GRAND AVE, SAINT PAUL, MN 55105
(612) 257-2391
Mailing address
1137 GRAND AVE, SAINT PAUL, MN 55105
(612) 257-2391
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305471
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305471
LADC LICENSE NUMBER
MN
Enumeration date
04/06/2020
Last updated
04/06/2020
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