Individual
JUDY ANN THOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LADC,LPCC
Contact information
Practice address
16123 GRANT UTLEY AVENUE, CASS LAKE, MN 56633
(218) 335-3050
(218) 335-4410
Mailing address
190 SAILSTAR DR NE, CASS LAKE, MN 56633-3565
(218) 335-3050
(218) 335-4410
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
301820
MN
101YM0800X
Mental Health Counselor
Primary
2286
MN
Other
Enumeration date
10/02/2008
Last updated
11/13/2019
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