Individual
CARRIE RENEE NILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1711 COUNTY ROAD B W, ROSEVILLE, MN 55113-4057
(651) 982-4792
Mailing address
1068 LAKE ST S, FOREST LAKE, MN 55025-2639
(651) 362-2008
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/20/2019
Last updated
04/23/2026
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