Individual
KENNETH PAUL BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
4048 LAKELAND AVE N # 22031, MINNEAPOLIS, MN 55422-2236
(612) 325-8357
Mailing address
4048 LAKELAND AVE N # 22031, MINNEAPOLIS, MN 55422-2236
(612) 325-8357
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1035173-1-CDT
MN
101YP2500X
Professional Counselor
Primary
520
MN
Other
Enumeration date
11/29/2010
Last updated
09/22/2021
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