Individual
STACEY LYNN TWEEDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1119 GRANT ST, JACKSON, MN 56143-1207
(507) 407-2177
(507) 540-1135
Mailing address
1119 GRANT ST, JACKSON, MN 56143-1207
(507) 841-2574
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302628
MN
101YP2500X
Professional Counselor
Primary
4087
MN
Other
Enumeration date
11/09/2017
Last updated
10/10/2024
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