Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LADC300693 | MN |
Y | 101YP2500X | Professional Counselor | LPCC000214 | MN |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | LPC00042 | MN |
NPI | 1245388875 |
---|---|
Provider Name | Kristeen Joanne Laplant Young |
First Address | Camp Pendleton, CA 92055-5020 |
Second Address | Plymouth, MN 55441-2304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 14/02/2019 |