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1366708109
ERIC THOMAS CLEMENSEN
SAINT PAUL, MN
NPI
1366708109
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 303592)
Enumeration Date
2012-04-05
Last Update Date
2014-07-10
Business Address
Mr. ERIC THOMAS CLEMENSEN BS, LADC, BCC
1609 JACKSON ST
SAINT PAUL, MN 55117-3917
Phone number: 612-326-7614
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Mailing Address
Mr. ERIC THOMAS CLEMENSEN BS, LADC, BCC
1609 JACKSON ST
SAINT PAUL, MN 55117-3917
Phone number: 612-326-7614
Copy
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