| Brave Defiance Consulting, Llc | |
|
6312 Welcome Ave N Brooklyn Park MN 55429-2047 | |
| (205) 451-7955 | |
| Not Available |
| Full Name | Brave Defiance Consulting, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6312 Welcome Ave N, Brooklyn Park, Minnesota |
| Authorized Official Name and Position | Aja Dionna King (COUNSELING PSYCHOLOGIST) |
| Authorized Official Contact | 2054517955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brave Defiance Consulting, Llc 6312 Welcome Ave N Brooklyn Park MN 55429-2047 Ph: (612) 470-1783 | Brave Defiance Consulting, Llc 6312 Welcome Ave N Brooklyn Park MN 55429-2047 Ph: (205) 451-7955 |
| NPI Number | 1003560681 |
|---|---|
| Provider Enumeration Date | 02/11/2022 |
| Last Update Date | 07/01/2024 |
| Certification Date | 07/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003560681 | NPI | - | NPPES |
| 0 | Other | 0 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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