Individual
MR. TODD ANTHONY ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC, BCCR
Contact information
Practice address
1315 PENN AVE N, MINNEAPOLIS, MN 55411-3047
(612) 767-9191
(612) 767-3542
Mailing address
804 JENKS AVE, SAINT PAUL, MN 55106-3136
(612) 501-8002
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301547
MN
Other
Enumeration date
06/16/2011
Last updated
06/16/2011
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