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Individual

PA XIONG NODALO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC, LADC

Contact information

Practice address
1250 MOORE LAKE DR E STE 152, FRIDLEY, MN 55432-5135
(612) 389-2332
(612) 389-2338
Mailing address
1250 MOORE LAKE DR E STE 152, FRIDLEY, MN 55432-5135
(612) 389-2332
(612) 389-2338

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304280
MN
101YP2500X
Professional Counselor
Primary
5183
MN

Other

Enumeration date
08/30/2016
Last updated
09/02/2025
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