Individual
BROOKS JOHN WALDRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3500 PERRY AVE N, CRYSTAL, MN 55422-2874
(612) 607-2908
Mailing address
3500 PERRY AVE N, CRYSTAL, MN 55422-2874
(612) 607-2908
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304133
MN
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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