Provider Demographics
NPI:1447585989
Name:STETSON, ROWLAND GEORGE (LADC,)
Entity Type:Individual
Prefix:MR
First Name:ROWLAND
Middle Name:GEORGE
Last Name:STETSON
Suffix:
Gender:M
Credentials:LADC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22803 COUNTY HIGHWAY 110
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-8202
Mailing Address - Country:US
Mailing Address - Phone:218-205-7829
Mailing Address - Fax:218-236-6765
Practice Address - Street 1:715 11TH ST N STE 204
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2000
Practice Address - Country:US
Practice Address - Phone:218-233-6398
Practice Address - Fax:218-233-6765
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302721101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)