Individual
JODI ANN BOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
3701 12TH STREET, SUITE 203, SAINT CLOUD, MN 56303
(320) 253-3512
(320) 253-1037
Mailing address
1900 SILVER LAKE ROAD NW, SUITE 110, NEW BRIGHTON, MN 55112
(651) 379-1718
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303816
MN
Other
Enumeration date
06/07/2016
Last updated
07/20/2016
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