Individual
MISS JERIS JEAN VAIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
505 S 12TH AVE W, VIRGINIA, MN 55792-3099
(218) 749-2877
(218) 749-6033
Mailing address
505 S 12TH AVE W, VIRGINIA, MN 55792-3099
(218) 749-2877
(218) 749-6033
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304245
MN
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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