Individual
EDWARD EVAN WEIBYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
525 PORTLAND AVE, MINNEAPOLIS, MN 55415-1533
(612) 267-5784
(612) 329-4320
Mailing address
525 PORTLAND AVE, MINNEAPOLIS, MN 55415-1533
(612) 267-5784
(612) 329-4320
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305637
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305637
BBHT (BOARD OF BEHAVIORAL HEALTH AND THERAPY
MN
Enumeration date
07/01/2020
Last updated
07/01/2020
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