Organization
COSAN LEIGHIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLLEEN ETZBACH RHD (OWNER/PSYCHOTHERAPIST)
(715) 279-8591
Entity
Organization
Contact information
Practice address
145 2ND ST W, WABASHA, MN 55981-1245
(715) 279-8591
Mailing address
145 2ND ST W, WABASHA, MN 55981-1245
(715) 279-8591
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/17/2023
Last updated
11/15/2024
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