| Boulevard Therapy | |
|
317 Wayzata Blvd E Wayzata MN 55391-1683 | |
| (612) 819-4278 | |
| Not Available |
| Full Name | Boulevard Therapy |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 317 Wayzata Blvd E, Wayzata, Minnesota |
| Authorized Official Name and Position | Melissa Patterson (COUNSELOR) |
| Authorized Official Contact | 6128194278 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulevard Therapy 317 Wayzata Blvd E Wayzata MN 55391-1683 Ph: (612) 819-4278 | Boulevard Therapy 317 Wayzata Blvd E Wayzata MN 55391-1683 Ph: (612) 819-4278 |
| NPI Number | 1144999087 |
|---|---|
| Provider Enumeration Date | 09/13/2021 |
| Last Update Date | 10/06/2021 |
| Certification Date | 10/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144999087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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