Individual
JANET KAY SMALLIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
5860 BAKER ROAD, MINNETONKA, MN 55345-5903
(952) 767-4200
(952) 767-4211
Mailing address
9535 DUNLAP AVE, CIRCLE PINES, MN 55014-3511
(763) 786-7812
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305834
MN
106S00000X
Behavior Technician
—
MN
Other
Enumeration date
10/14/2020
Last updated
07/19/2024
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