Individual
IVES KENNETH WITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
1828 JEFFERSON ST NE, MINNEAPOLIS, MN 55418-4427
(651) 245-0417
Mailing address
767 HEINEL DR, ROSEVILLE, MN 55113-2152
(612) 741-2152
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC02438
MN
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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