Organization
PROFESSIONAL RECOVERY ORGANIZATION NETWORK, LLC
Active
Other names
PRO NETWORK
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELINDA RAE COSCARELLI PHD (OWNER)
(507) 951-9980
Entity
Organization
Contact information
Practice address
1687 WOODLANE DR STE 208, WOODBURY, MN 55125-3047
(507) 951-9980
Mailing address
47842 BLUE HERON TRL, RUSH CITY, MN 55069-2803
(507) 951-9980
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598134645
—
MN
Enumeration date
03/17/2022
Last updated
03/20/2022
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