Individual
NATHAN MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1833 3RD AVE, ANOKA, MN 55303-2424
(763) 234-1122
Mailing address
15172 UPLANDER ST NW, ANDOVER, MN 55304-2659
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
02882
MN
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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