| The Family Development Center, Llc | |
|
475 Cleveland Ave N Suite 316 Saint Paul MN 55104-5031 | |
| (612) 799-0862 | |
| Not Available |
| Full Name | The Family Development Center, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 475 Cleveland Ave N, Saint Paul, Minnesota |
| Authorized Official Name and Position | Alyssa Wright (CO-OWNER) |
| Authorized Official Contact | 6127990862 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Family Development Center, Llc 475 Cleveland Ave N Suite 316 Saint Paul MN 55104-5031 Ph: () - | The Family Development Center, Llc 475 Cleveland Ave N Suite 316 Saint Paul MN 55104-5031 Ph: (612) 799-0862 |
| NPI Number | 1780015511 |
|---|---|
| Provider Enumeration Date | 12/04/2013 |
| Last Update Date | 12/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780015511 | NPI | - | NPPES |
| 067948800 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1539 (Minnesota) | Primary |
| 106H00000X | Marriage & Family Therapist | 1978 (Minnesota) | Secondary |
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