TIMOTHY RICHARD BRUSTAD

NEW BRIGHTON, MN
NPI1700953353
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN  300677)
Enumeration Date2006-11-29
Last Update Date2007-07-08
Business Address
Mr. TIMOTHY RICHARD BRUSTAD L.A.D.C.
626 CONTINENTAL DR
NEW BRIGHTON, MN 55112-7641
Phone number: 651-341-0618
Mailing Address
Mr. TIMOTHY RICHARD BRUSTAD L.A.D.C.
626 CONTINENTAL DR
NEW BRIGHTON, MN 55112-7641
Phone number: 651-341-0618
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