Individual
SUSAN MARIE WISH DEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, ATR-BC
Contact information
Practice address
5899 SUNNYBROOK LN, MOUND, MN 55364-1280
(612) 308-1622
Mailing address
5899 SUNNYBROOK LN, MOUND, MN 55364-1280
(612) 308-1622
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/27/2013
Last updated
04/27/2013
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