Individual
STACY OVERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
332 W SUPERIOR ST, SUITE 300, DULUTH, MN 55802-1808
(218) 722-4379
(218) 722-4333
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302901
MN
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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