person
Loretta Jayne Bach Gansen, LADC
Addiction (Substance Use Disorder) Counselor in Park Rapids, Minnesota
NPI 1164656989

Loretta Jayne Bach Gansen is an Addiction (Substance Use Disorder) Counselor based in Park Rapids, MN and is specialized in Addiction (Substance Use Disorder). Loretta Jayne Bach Gansen practices in Park Rapids, MN and has the professional credentials of LADC. The NPI Number for Loretta Jayne Bach Gansen is 1164656989 and holds a License No. 300392 (Minnesota).

The current practice location address for Loretta Jayne Bach Gansen is 515 Bridge St, Park Rapids, MN and can be reached out via phone at 218-366-9229 and via fax at 218-237-2520.

Location: 515 Bridge St, Park Rapids, MN, 56470-1210
person
Provider Profile Details
NPI Number
1164656989
Provider Name
Loretta Jayne Bach Gansen
Credential
LADC
Provider Entity Type
Individual
Gender
Female
Address
515 Bridge St, Park Rapids, MN, 56470-1210
Phone Number
218-366-9229
Fax Number
218-237-2520
Provider Enumeration Date
05/07/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1164656989 01 MN LADC
institution
Provider Business Practice Location Address Details
Address
515 Bridge St
City
State
Zip
56470-1210
Phone Number
218-366-9229
Fax Number
218-237-2520
person
Provider Business Mailing Address Details
Address
515 Bridge St
City
State
Zip
56470-1210
Phone Number
218-366-9229
Fax Number
218-237-2520
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
300392 (Minnesota)
Definition
Definition to come...
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