Healthcare Provider Details

I. General information

NPI: 1063331080
Provider Name (Legal Business Name): SAVAN PREAP LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 UNIVERSITY AVE W STE 128
SAINT PAUL MN
55104-2891
US

IV. Provider business mailing address

4 RITA LN
CHASKA MN
55318-1264
US

V. Phone/Fax

Practice location:
  • Phone: 651-358-3152
  • Fax: 651-493-4204
Mailing address:
  • Phone: 612-407-2604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number307510
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: