Individual
LONI RUTHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4306 65TH AVE N, MINNEAPOLIS, MN 55429-2108
(612) 442-5462
Mailing address
4306 65TH AVE N, MINNEAPOLIS, MN 55429-2108
(612) 442-5462
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306963
MN
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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