Individual
NICOLE GORNOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, ATR
Contact information
Practice address
2001 BEAM AVE, MAPLEWOOD, MN 55109-1401
(952) 737-4520
Mailing address
1917 ARTHUR ST NE, MINNEAPOLIS, MN 55418-4705
(612) 718-2389
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC03409
MN
221700000X
Art Therapist
—
MN
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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