| Bethany Christian Services Of Minnesota | |
|
3131 Fernbrook Ln N Ste 204 Plymouth MN 55447-5337 | |
| (763) 553-0344 | |
| (763) 553-0117 |
| Full Name | Bethany Christian Services Of Minnesota |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3131 Fernbrook Ln N Ste 204, Plymouth, Minnesota |
| Authorized Official Name and Position | Gloria Peterson (CLINICIAN) |
| Authorized Official Contact | 7635530344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany Christian Services Of Minnesota 3131 Fernbrook Ln N Ste 204 Plymouth MN 55447-5337 Ph: (763) 553-0344 | Bethany Christian Services Of Minnesota 3131 Fernbrook Ln N Ste 204 Plymouth MN 55447-5337 Ph: (763) 553-0344 |
| NPI Number | 1285074039 |
|---|---|
| Provider Enumeration Date | 06/26/2013 |
| Last Update Date | 03/31/2020 |
| Certification Date | 03/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285074039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 00747 (Minnesota) | Primary |
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