Individual
TERRY SYLVESTER MADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
222 9TH AVE W, ALEXANDRIA, MN 56308-2221
(320) 763-3912
(320) 763-6629
Mailing address
222 9TH AVE W, ALEXANDRIA, MN 56308-2221
(320) 763-3912
(320) 763-6629
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301762
MN
Other
Enumeration date
10/03/2008
Last updated
10/03/2008
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