Individual
MR. JEREMY TAYLOR KRENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC, LICSW
Contact information
Practice address
3701 12TH ST N STE 201, SAINT CLOUD, MN 56303-2253
(320) 229-3760
(320) 229-3764
Mailing address
3701 12TH ST N STE 201, SAINT CLOUD, MN 56303-2253
(320) 229-3760
(320) 229-3764
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303541
MN
1041C0700X
Clinical Social Worker
Primary
28258
MN
Other
Enumeration date
03/27/2019
Last updated
10/19/2021
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