Individual
NICOLE M SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2369 109TH AVE NW, COON RAPIDS, MN 55433-4156
(763) 506-2800
Mailing address
2369 109TH AVE NW, COON RAPIDS, MN 55433-4156
(763) 506-2800
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1901
MN
Other
Enumeration date
11/05/2014
Last updated
11/05/2014
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