LEO FRED VICKERMAN

MINNEAPOLIS, MN
NPI1548490048
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN  302510)
Enumeration Date2009-07-17
Last Update Date2009-07-17
Business Address
-- LEO FRED VICKERMAN LADC
1132 CENTRAL AVE NE
MINNEAPOLIS, MN 55413-1512
Phone number: 612-236-1700
Mailing Address
-- LEO FRED VICKERMAN LADC
1121 JACKSON ST NE SUITE 105
MINNEAPOLIS, MN 55413-1672
Phone number:
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