Individual
KEITH MICHAEL TERHAAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6776 LAKE DR, 210, LINO LAKES, MN 55014-1191
(763) 245-7786
Mailing address
2005 141ST LN NE, HAM LAKE, MN 55304-6841
(763) 245-7786
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC00833
MN
Other
Enumeration date
11/16/2010
Last updated
11/16/2010
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