Individual
COREY JOHN ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
652 BIELENBERG DR STE 103, WOODBURY, MN 55125-4419
(612) 430-9181
Mailing address
2330 LEXINGTON AVE S APT 206, MENDOTA HEIGHTS, MN 55120-1225
(651) 815-9891
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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