Individual
MISS CONNIE MAE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.F.T
Contact information
Practice address
1555 BENDER RD, CHASKA, MN 55318-2613
(612) 616-6113
Mailing address
1555 BENDER RD, CHASKA, MN 55318-2613
(612) 616-6113
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1051
MN
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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