Individual
TOMMIE DICK NUESSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LGSW
Contact information
Practice address
27679 BLACK FOREST PASS, RANDALL, MN 56475-2156
(218) 251-1868
Mailing address
27679 BLACK FOREST PASS, RANDALL, MN 56475-2156
(218) 251-1868
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
20209
MN
1041C0700X
Clinical Social Worker
—
MN
Other
Enumeration date
10/19/2011
Last updated
02/03/2012
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