| Evolve Health Llc | |
|
5821 Cedar Lake Rd S Suite 8 St Louis Park MN 55416-1487 | |
| (612) 245-8661 | |
| Not Available |
| Full Name | Evolve Health Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 5821 Cedar Lake Rd S, St Louis Park, Minnesota |
| Authorized Official Name and Position | Kelly Blondell (OWNER/THERAPIST) |
| Authorized Official Contact | 6122458661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Health Llc 5821 Cedar Lake Rd S Suite 8 St Louis Park MN 55416-1487 Ph: (612) 245-8661 | Evolve Health Llc 5821 Cedar Lake Rd S Suite 8 St Louis Park MN 55416-1487 Ph: (612) 245-8661 |
| NPI Number | 1285177402 |
|---|---|
| Provider Enumeration Date | 11/19/2016 |
| Last Update Date | 11/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285177402 | NPI | - | NPPES |
| 1699923359 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1658 (Minnesota) | Primary |
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