Individual
NICHOLE MARIE MARTINEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
13603 80TH CIR N, MAPLE GROVE, MN 55369-8961
(763) 274-3120
(763) 274-3121
Mailing address
13603 80TH CIR N, MAPLE GROVE, MN 55369-8961
(763) 274-3120
(763) 274-3121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303744
MN
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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