NPI Profile for AMANDA NICKABOINE MEYER in ONAMIA, MN.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI Number | 1861769986 |
|
| Status | Active | |
| Credentials | LADC | |
| Entity | Individual | |
| Enumeration date | 11/17/2011 | |
| Last updated | 11/17/2011 - About 15 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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