Provider Demographics
NPI:1578069977
Name:ASPLUND, MARIA LOUISA (LADC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LOUISA
Last Name:ASPLUND
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:LOUISE
Other - Last Name:ORTIZ RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:516 S POKEGAMA AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3800
Mailing Address - Country:US
Mailing Address - Phone:218-327-2001
Mailing Address - Fax:218-327-0456
Practice Address - Street 1:516 S POKEGAMA AVE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-3800
Practice Address - Country:US
Practice Address - Phone:218-327-2001
Practice Address - Fax:218-327-0456
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305099101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)