Individual
MELISSA ANN POEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
410 MARTIN AVE, BIG LAKE, MN 55309-8004
(763) 607-6344
Mailing address
410 MARTIN AVE, BIG LAKE, MN 55309-8004
(763) 607-6344
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302424
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
302424
MN BOARD OF BEHAVIORAL HEALTH LICENSE
MN
Enumeration date
12/05/2017
Last updated
12/05/2017
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