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Individual

MR. MICHAEL WILLIAM MAHONEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC, NCAC1

Contact information

Practice address
1530 ASSISI DR NW, ROCHESTER, MN 55901-1637
(507) 218-3450
(855) 856-5734
Mailing address
1530 ASSISI DR NW, ROCHESTER, MN 55901-1637
(507) 218-3450
(855) 856-5734

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301050
MN

Other

Enumeration date
03/28/2014
Last updated
03/28/2014
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