Individual
TAYLOR WALDVOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
2040 WOODWINDS DR, WOODBURY, MN 55125-2522
(651) 259-9750
Mailing address
2040 WOODWINDS DR, WOODBURY, MN 55125-2522
(651) 259-9750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305861
MN
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
CC04281
MN
Other
Enumeration date
10/11/2023
Last updated
04/17/2024
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