Larry W Boomgaarden, B.A., LAC-T
Counselor, Addiction (Substance Use Disorder) in Detroit Lakes, MN. Individual provider (NPI-1).
NPI number1295964518
StatusActive
Last updated in NPPESMay 2, 2018
Details
- NPI
- 1295964518
- Entity type
- Individual (NPI-1)
- Name
- Larry W Boomgaarden
- Credential
- B.A., LAC-T
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2009
- Last updated
- May 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
1000 8th St SeDetroit Lakes, MN 56501-2819
Phone 218-847-0696 · Fax 218-847-4198
Mailing address
1000 8th St SeDetroit Lakes, MN 56501-2819
Phone 218-847-0696 · Fax 218-847-4198
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All 23 Addiction (Substance Use Disorder) Counselor providers in Detroit Lakes · All 554 providers in Detroit Lakes
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