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Individual

TRISTAN LADEL CARTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(612) 872-0727
Mailing address
2118 BLAISDELL AVE, MINNEAPOLIS, MN 55404-2415
(612) 872-0727

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306300
MN

Other

Enumeration date
02/07/2022
Last updated
02/07/2022
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