Individual
DONALD SHOPE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC, CAP
Contact information
Practice address
4496 LEXINGTON AVE N, SHOREVIEW, MN 55126-2235
(561) 729-8368
Mailing address
4496 LEXINGTON AVE N, SHOREVIEW, MN 55126-2235
(561) 729-8368
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301362
MN
Other
Enumeration date
02/08/2018
Last updated
02/08/2018
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