| Theraplace Llc | |
|
6448 Main St Ste 15 North Branch MN 55056-7068 | |
| (651) 775-9804 | |
| Not Available |
| Full Name | Theraplace Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 6448 Main St Ste 15, North Branch, Minnesota |
| Authorized Official Name and Position | Felicia O'brien (OWNER) |
| Authorized Official Contact | 6517759804 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theraplace Llc Po Box 547 6448 Main Street, Suite 15 North Branch MN 55056-0547 Ph: (651) 775-9804 | Theraplace Llc 6448 Main St Ste 15 North Branch MN 55056-7068 Ph: (651) 775-9804 |
| NPI Number | 1346788221 |
|---|---|
| Provider Enumeration Date | 02/10/2017 |
| Last Update Date | 02/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346788221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | LMFT2935 (Minnesota) | Primary |
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