Individual
MISS MICHELLE MARIE DIFFENBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
1885 UNIVERSITY AVE, SUITE 246, ST. PAUL, MN 55104-3489
(612) 326-7563
(651) 647-9147
Mailing address
1885 UNIVERSITY AVE, SUITE 246, ST. PAUL, MN 55104
(612) 326-7563
(651) 647-9147
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302501
MN
Other
Enumeration date
04/13/2011
Last updated
04/13/2011
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