Individual
MR. ERIC THOMAS CLEMENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, LADC, BCC
Contact information
Practice address
1609 JACKSON ST, SAINT PAUL, MN 55117-3917
(612) 326-7614
(651) 488-5658
Mailing address
1609 JACKSON ST, SAINT PAUL, MN 55117-3917
(612) 326-7614
(651) 488-5658
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303592
MN
Other
Enumeration date
04/05/2012
Last updated
07/10/2014
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