Individual
MICHAEL JOHN MADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
375 ORLEANS ST E, STILLWATER, MN 55082-5830
(612) 368-5713
Mailing address
375 ORLEANS ST E, STILLWATER, MN 55082-5830
(612) 368-5713
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305816
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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