Individual
MR. EDWIN JADE MAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC BA
Contact information
Practice address
7590 LYRIC LANE NE, UNITY HOSPITAL, FRIDLEY, MN 55432
(763) 236-9300
(763) 236-4370
Mailing address
5603 HALIFAX AVE NORTH, BROOKLY LEMEN, MN 55429
(763) 536-8787
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301815
MN
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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