Individual
MICHAEL ENSTAD BOEVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
6063 HUDSON RD STE 200, WOODBURY, MN 55125-4455
(952) 460-9015
Mailing address
6063 HUDSON RD STE 200, WOODBURY, MN 55125-4455
(952) 460-9015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4274
MN
101YP2500X
Professional Counselor
Primary
4274
MN
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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