Individual
LYDIA BOEHLKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1031 GRACE ST, SAINT PETER, MN 56082-1300
(507) 364-5312
(507) 322-1008
Mailing address
32298 STATE HIGHWAY 13, MONTGOMERY, MN 56069-4348
(507) 364-5312
(507) 322-1008
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306772
MN
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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