Individual
ANDREA WARD ENOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1983 SLOAN PL STE 16, MAPLEWOOD, MN 55117-2004
(651) 340-2439
(651) 340-2163
Mailing address
1983 SLOAN PL STE 16, MAPLEWOOD, MN 55117-2004
(651) 340-2439
(651) 340-2163
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303568
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303568
—
MN
Enumeration date
06/12/2019
Last updated
06/12/2019
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