Michael Graham Waxlax, LADC, LPCC

NPI #1801506704 in Mora, Minnesota

Provider Information

NPI Number: 1801506704
Entity Type: Individual
Name: Michael Graham Waxlax, LADC, LPCC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LADC, LPCC
Enumeration Date: Dec 1, 2022
Last Updated: Mar 6, 2024

Practice Location

Address: 230 1ST ST
City: Mora
State: Minnesota
ZIP Code: 55051-1330
Phone: (218) 969-1943

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X	Primary

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