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Individual

KATIE RSTOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
304 BELLE AVE, MANKATO, MN 56001-5250
(877) 877-2230
(507) 769-0816
Mailing address
1737 LA MAR DR, NORTH MANKATO, MN 56003-1558
(507) 381-0698

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
225C00000X
Rehabilitation Counselor
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/20/2023
Last updated
03/20/2023
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