Individual
APRIL MIA VANISEGHEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
222 9TH AVE W, ALEXANDRIA, MN 56308-2221
(320) 763-3912
Mailing address
307 13TH ST S, BUFFALO, MN 55313-1232
(612) 388-9533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303994
MN
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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