Individual provider · Type 1 NPI
Bradley A. Gangnon, LADC, ADCR-MN CPRS
Addiction (Substance Use Disorder) Counselor · Minneapolis, MN
NPI number
1225715097
Active
Practice location
1516 W Lake St # 205
Minneapolis, MN 55408-2554
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 305379 (MN) |
| Rehabilitation Practitioner | 225400000X | 10053940 |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1225715097
Bradley A. Gangnon, LADC, ADCR-MN CPRS's National Provider Identifier is 1225715097, issued on Jul 3, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Minneapolis, MN. The record was last updated on Jul 3, 2023.