Individual
MRS. JADE MATRACA BLASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LADC, LGSW
Contact information
Practice address
1230 SCHOOL ST NW, ELK RIVER, MN 55330-2422
(763) 241-3558
Mailing address
23299 IVYWOOD ST NW, SAINT FRANCIS, MN 55070-8742
(763) 226-9781
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303984
MN
1041C0700X
Clinical Social Worker
Primary
28295
MN
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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