Individual
DIANE BRANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13603 80TH CIR N, MAPLE GROVE, MN 55369-8961
(763) 274-2120
Mailing address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC02178
MN
Other
Enumeration date
10/22/2019
Last updated
10/30/2019
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