Individual
INNOCENT A CHITULANGDMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2003 10TH AVE S STE 6, MINNEAPOLIS, MN 55404-6606
(952) 649-0512
Mailing address
11395 WESTWIND DR APT B, EDEN PRAIRIE, MN 55344-4207
(952) 649-0512
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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