Individual
LANCE E PETSCHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
1404 CENTRAL AVE NE, MINNEAPOLIS, MN 55413-1517
(612) 286-0525
Mailing address
1404 CENTRAL AVE NE, MINNEAPOLIS, MN 55413-1517
(651) 333-6174
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
03420
MN
Other
Enumeration date
10/23/2020
Last updated
04/02/2024
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