Individual
HAYWARD CORKER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 GOLDEN VALLEY RD, MINNEAPOLIS, MN 55411-3139
(612) 302-4109
(612) 520-0047
Mailing address
1500 GOLDEN VALLEY RD, MINNEAPOLIS, MN 55411-3139
(612) 302-4109
(612) 520-0047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301563
MN
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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