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Individual

OLIVER BUSETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(800) 743-6551
Mailing address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1274
ND
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302874
MN

Other

Enumeration date
07/27/2010
Last updated
07/27/2010
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