Individual
TIFFANY RIESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
332 W SUPERIOR STREET, SUITE 300, DULUTH, MN 55802
(218) 722-4379
(218) 722-4333
Mailing address
1900 SILVER LAKE ROAD NW, SUITE 110, NEW BRIGHTON, MN 55112
(651) 379-1718
(651) 379-1738
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304399
MN
Other
Enumeration date
09/02/2016
Last updated
09/23/2016
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