Individual provider · Type 1 NPI
Lola Marie Booth, LADC
Addiction (Substance Use Disorder) Counselor · Detroit Lakes, MN
NPI number
1093480949
Active
Practice location
921 8th St SE
Detroit Lakes, MN 56501-2840
Mailing address
921 8th Street Southeast
Detroit Lakes, MN 56501-4219
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 305800 (MN) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
2 other providers at this address
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About NPI 1093480949
Lola Marie Booth, LADC's National Provider Identifier is 1093480949, issued on Aug 12, 2021. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Detroit Lakes, MN. The record was last updated on Oct 3, 2021.