Individual
LUKE GOETTLICHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
3833 COON RAPIDS BLVD NW STE 120, COON RAPIDS, MN 55433-2599
(763) 767-3350
(763) 767-0912
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302300
MN
Other
Enumeration date
09/17/2013
Last updated
12/13/2018
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