Individual
COOLIDGE E DENNIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
3052 LAKE ST N, MAPLEWOOD, MN 55109-1622
(651) 207-9518
Mailing address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
(651) 207-9518
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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