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1891297024
ALICE ETHEL NORDLUM
NORTH BRANCH, MN
NPI
1891297024
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: MN 304361)
Enumeration Date
2018-03-04
Last Update Date
2018-03-04
Business Address
ALICE ETHEL NORDLUM
5842 OLD MAIN ST STE 2
NORTH BRANCH, MN 55056-6687
Phone number: 651-401-3068
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Mailing Address
ALICE ETHEL NORDLUM
1175 N RYAN LAKE RD NE
ISANTI, MN 55040-6146
Phone number: 763-607-7284
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