Individual
PAMELA PAIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2042 WOODDALE DR STE 220, WOODBURY, MN 55125-4421
(651) 734-9633
Mailing address
2042 WOODDALE DR STE 220, WOODBURY, MN 55125-4421
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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