Individual
MELINDA JO GENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
5458 LAKE WASHBURN RD NE, OUTING, MN 56662-4460
(218) 851-7904
Mailing address
5458 LAKE WASHBURN RD NE, OUTING, MN 56662-4460
(218) 851-7904
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305667
MN
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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