JEFFREY DONALD LARSON

MILACA, MN
NPI1023575263
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN  300814)
Enumeration Date2019-02-25
Last Update Date2021-04-15
Business Address
JEFFREY DONALD LARSON LADC
11735 90TH AVE
MILACA, MN 56353-3894
Phone number: 612-251-8206
Mailing Address
JEFFREY DONALD LARSON LADC
11735 90TH AVE
MILACA, MN 56353-3894
Phone number:
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