Individual
DEBRA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 W 66TH ST STE 400, EDINA, MN 55435-2134
(952) 914-1905
Mailing address
3400 W 66TH ST STE 400, EDINA, MN 55435-2134
(952) 914-1905
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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