| Silver Birch Therapy Pllc | |
|
905 Stanley Ave Cloquet MN 55720-3186 | |
| (612) 876-6586 | |
| (185) 851-5862 |
| Full Name | Silver Birch Therapy Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 905 Stanley Ave, Cloquet, Minnesota |
| Authorized Official Name and Position | Amy Vredenburgh (OWNER) |
| Authorized Official Contact | 6128766586 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Silver Birch Therapy Pllc 9450 Sw Gemini Dr Pmb 14034 Beaverton OR 97008-5842 Ph: (612) 876-6586 | Silver Birch Therapy Pllc 905 Stanley Ave Cloquet MN 55720-3186 Ph: (612) 876-6586 |
| NPI Number | 1659878742 |
|---|---|
| Provider Enumeration Date | 04/06/2018 |
| Last Update Date | 06/02/2021 |
| Certification Date | 06/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659878742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 2962 (Minnesota) | Primary |
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