Individual
MICHELLE LEE VESLEDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
2055 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-3716
(651) 289-1211
(651) 289-1215
Mailing address
3983 RIVERTON AVE, EAGAN, MN 55122-1761
(651) 398-2765
(651) 289-1215
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305207
MN
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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