Individual
PHILLIP HUERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 457-4447
Mailing address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 457-4447
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304385
MN
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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