Individual
SHANNON BOOKWALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
6058 HIGHWAY 10 NW, ANOKA, MN 55303-4530
(763) 421-5590
Mailing address
6058 HIGHWAY 10 NW, ANOKA, MN 55303-4530
(763) 421-5590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304535
MN
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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