Individual
NANCY RAICHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1403 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-6398
(651) 633-4532
Mailing address
12366 JOHNSON ST NE, BLAINE, MN 55434-2834
(763) 227-8361
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302650
MN
Other
Enumeration date
11/25/2013
Last updated
11/25/2013
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