Individual
ANNA MARIE CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
25704 COUNTY ROAD 338, BOVEY, MN 55709-6566
(218) 245-1395
(218) 245-1380
Mailing address
25704 COUNTY ROAD 338, BOVEY, MN 55709-6566
(218) 245-1395
(218) 245-1380
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1040263
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215005400
—
MN
Enumeration date
01/23/2023
Last updated
01/23/2023
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