Individual provider · Type 1 NPI
Edwin Jade Maki, LADC BA
Addiction (Substance Use Disorder) Counselor · Fridley, MN
NPI number
1962598292
Active
Practice location
7590 Lyric Lane NE, Unity Hospital
Fridley, MN 55432
Fax (763) 236-4370
Mailing address
5603 Halifax Ave North
Brookly Lemen, MN 55429
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 301815 (MN) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
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About NPI 1962598292
Edwin Jade Maki, LADC BA's National Provider Identifier is 1962598292, issued on Oct 5, 2006. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fridley, MN. The record was last updated on Jul 8, 2007.