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Individual

ANIKA LAUREN WALSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED., LPCC

Contact information

Practice address
819 30TH AVE S STE 208, MOORHEAD, MN 56560-5054
(651) 313-8080
Mailing address
819 30TH AVE S STE 208, MOORHEAD, MN 56560-5054

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1208-6-15-22-580
ND
101YP2500X
Professional Counselor
Primary
5001
MN

Other

Enumeration date
06/27/2024
Last updated
10/09/2025
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