Joshua Eric Macomber, LADC
Counselor, Addiction (Substance Use Disorder) in Minneapolis, MN. Individual provider (NPI-1).
NPI number1962068643
StatusActive
Last updated in NPPESMay 17, 2019
Details
- NPI
- 1962068643
- Entity type
- Individual (NPI-1)
- Name
- Mr. Joshua Eric Macomber
- Credential
- LADC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 17, 2019
- Last updated
- May 17, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 305344 | MN | Yes |
Practice location
2419 Nicollet AveMinneapolis, MN 55404-3450
Phone 612-708-6268
Mailing address
821 E 22nd StMinneapolis, MN 55404-2810
Phone 612-708-6268
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