Healthcare Provider Details

I. General information

NPI: 1750398475
Provider Name (Legal Business Name): CHARITY LYNN HOVRE MS, CRC, CVE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 VETERANS DR 656/MH-116B
SAINT CLOUD MN
56303-2015
US

IV. Provider business mailing address

4801 VETERANS DR 656/MH-116B
SAINT CLOUD MN
56303-2015
US

V. Phone/Fax

Practice location:
  • Phone: 320-255-6424
  • Fax: 320-255-6472
Mailing address:
  • Phone: 320-255-6424
  • Fax: 320-255-6472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: