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Individual

ROBERT HERBERT SUTTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6200 EXCELSIOR BLVD STE 203, ST LOUIS PARK, MN 55416-2734
(952) 548-9340
(952) 548-9350
Mailing address
6200 EXCELSIOR BLVD STE 204, MINNEAPOLIS, MN 55416-2734
(952) 548-9340
(952) 548-9350

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301693
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LADC
LADC
MN
Enumeration date
01/15/2019
Last updated
01/15/2019
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