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Individual

MRS. CHARLY CANDAS VANGRINSVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.S.,LADC

Contact information

Practice address
1705 ANNE ST NW, BEMIDJI, MN 56601-6151
(218) 333-5000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
303368
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
1051960
MN
1041C0700X
Clinical Social Worker
Primary
27157
MN

Other

Enumeration date
11/04/2015
Last updated
10/16/2024
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