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PROF. ROSEMARY B WILLIAMS BCCR-LADC

Addiction Substance Use Disorder

Saint Paul, Minnesota

Provider NPI: 1740288893

Provider Information:
PROF. ROSEMARY B WILLIAMS BCCR-LADC
Gender: F
Not Sole Proprietor

Practice Location:
118 VICTORIA ST N  SAINT PAUL, MN 55104 US
Tel: 651-224-6200  Fax: 651-221-0457

Business Mailing Address:
2103 LYNDALE AVE N  MINNEAPOLIS, MN 55411 US
Tel: 612-529-8874  Fax: 612-529-2050

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
MN1026269-CDT

Other Provider Identifiers:

IssuerNumberStateType
BLUECROSS&BLUE SHEILD #6J72RAMN01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS MN - Page 1



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