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1609381557
NICHOLAS THELEN
ROSEVILLE, MN
NPI
1609381557
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 303546)
Enumeration Date
2017-12-13
Last Update Date
2017-12-13
Business Address
NICHOLAS THELEN MA LADC
2311 WOODBRIDGE ST
ROSEVILLE, MN 55113-4710
Phone number: 651-773-0832
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Mailing Address
NICHOLAS THELEN MA LADC
2311 WOODBRIDGE ST
ROSEVILLE, MN 55113-4710
Phone number:
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