Individual
MR. JON M HOLTHUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
713 ANDERSON AVE, SAINT CLOUD, MN 56303-2048
(320) 229-3760
Mailing address
713 ANDERSON AVE, SAINT CLOUD, MN 56303-2048
(320) 229-3760
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MN
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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