Individual
STACY LYNN BURRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1906 5TH AVE SE, LITTLE FALLS, MN 56345-3317
(320) 632-6647
Mailing address
37863 186TH AVE, AVON, MN 56310-8704
(320) 237-0688
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305223
MN
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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