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1164198867
BRIANNA THERESE FOURDYCE
NEW BRIGHTON, MN
NPI
1164198867
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-08-21
Last Update Date
2021-08-21
Business Address
BRIANNA THERESE FOURDYCE
1900 SILVER LAKE RD NW STE 110
NEW BRIGHTON, MN 55112-1789
Phone number: 651-628-9566
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Mailing Address
BRIANNA THERESE FOURDYCE
1900 SILVER LAKE RD NW STE 110
NEW BRIGHTON, MN 55112-1789
Phone number: 651-628-9566
Copy
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