INTEGRATED LIFE COUNSELING CENTER, PLLC
Organization (NPI-2)
Active
Psychologist, Clinical
Provider Information
- NPI Number
1649644634- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 8931 33RD STREET N, LAKE ELMO, MN, 550428900
- Phone
- (651) 242-9608
- Fax
- (651) 756-8138
Specialties & Taxonomies
Counselor, Professional
License: MN #cc00241
Marriage & Family Therapist
License: MN #920
Marriage & Family Therapist
License: MN #2005
Psychologist, Clinical
Primary License: MN #LP3782