Individual
BROOKE MIMMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
13045 FALCON DR STE 100, BAXTER, MN 56425-4201
(218) 829-9207
Mailing address
16300 BIRCHWOOD LN, BRAINERD, MN 56401-6184
(218) 330-2175
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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