Individual
MARIE BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4140 THIELMAN LN, SAINT CLOUD, MN 56301-7326
(320) 253-5930
Mailing address
PO BOX 9859, FARGO, ND 58106-9859
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
01569
MN
Other
Enumeration date
12/15/2015
Last updated
12/15/2015
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