Individual
ANGELA STAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
621 W LAKE ST, LYNLAKE BLDG #350, MINNEAPOLIS, MN 55408-2949
(651) 308-1133
(612) 486-8800
Mailing address
2419 NEBRASKA AVE E, MAPLEWOOD, MN 55119-7174
(651) 308-1133
(651) 772-3183
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304238
MN
1041C0700X
Clinical Social Worker
Primary
8343
MN
Other
Enumeration date
11/03/2015
Last updated
08/24/2016
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