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General NPI Number Information
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NPI Number | 1497567507
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Entity Type | Individual
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Provider Name | MARC A LETENDRE MSED
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Gender | Male
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 222 W SUPERIOR ST STE 200
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City | DULUTH
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State | MN
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Zip | 55802-1939
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Country | US
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Telephone | 218-606-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 1016 GRANDVIEW AVE
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City | DULUTH
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State | MN
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Zip | 55812-1148
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Country | US
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Telephone | 218-590-4030
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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