Individual
STACY MAE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 LABREE AVE S, THIEF RIVER FALLS, MN 56701-2819
(218) 683-4318
(218) 683-4515
Mailing address
120 LABREE AVE S, THIEF RIVER FALLS, MN 56701-2819
(218) 683-4318
(218) 683-4515
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304338
MN
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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