Individual
MARYANN UNDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
2200 E FRANKLIN AVE, MINNEAPOLIS, MN 55404-2250
(612) 874-9811
(612) 874-9820
Mailing address
2200 E FRANKLIN AVE, MINNEAPOLIS, MN 55404-2250
(612) 874-9811
(612) 874-9820
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301953
MN
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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