Individual
AMANDA VESTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LADC
Contact information
Practice address
299 COON RAPIDS BLVD NW STE 100, COON RAPIDS, MN 55433-5869
(651) 240-2206
(612) 466-5677
Mailing address
299 COON RAPIDS BLVD NW STE 100, COON RAPIDS, MN 55433-5869
(651) 728-4505
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305175
MN
101YM0800X
Mental Health Counselor
Primary
CC04032
MN
Other
Enumeration date
07/12/2021
Last updated
12/09/2024
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