Individual
AMBER MAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2030 RAHN WAY, EAGAN, MN 55122-2300
(651) 529-1976
Mailing address
2030 RAHN WAY, EAGAN, MN 55122-2300
(651) 529-1976
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC01568
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CC01568
—
MN
Enumeration date
09/05/2017
Last updated
09/05/2017
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