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Individual

SARAH JAYNE LITCHKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
213 SE 11TH ST, GRAND RAPIDS, MN 55744-3970
(218) 327-1890
Mailing address
213 SE 11TH ST, GRAND RAPIDS, MN 55744-3970
(218) 327-1890

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302575
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1972792935
BCBS
MN
01
1972792935
MEDICA
05
1972792935
MN
Enumeration date
03/09/2009
Last updated
03/09/2009
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