Individual
KATHLEEN M WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1404 CENTRAL AVE NE, MINNEAPOLIS, MN 55413-1517
(612) 419-6788
Mailing address
1404 CENTRAL AVE NE, MINNEAPOLIS, MN 55413-1517
(612) 419-6788
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305069
MN
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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