Individual
JOSE PICON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, LADC
Contact information
Practice address
797 7TH ST E, SAINT PAUL, MN 55106-5014
(651) 379-4300
Mailing address
797 7TH ST E, SAINT PAUL, MN 55106-5014
(651) 379-4300
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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