Individual
NICOLE MARIE-ANGE OVERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, LADC
Contact information
Practice address
14040 NORTHDALE BLVD STE 100, ROGERS, MN 55374-9612
(763) 488-4100
(763) 488-4105
Mailing address
1160 LAKE ST N, BIG LAKE, MN 55309-9499
(320) 282-3528
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304650
MN
106H00000X
Marriage & Family Therapist
Primary
3404
MN
Other
Enumeration date
10/11/2017
Last updated
08/08/2019
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