| Wise Body Wise Mind, Llc | |
|
38868 12th Ave # 1032 North Branch MN 55056-6658 | |
| (612) 707-1504 | |
| Not Available |
| Full Name | Wise Body Wise Mind, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 38868 12th Ave # 1032, North Branch, Minnesota |
| Authorized Official Name and Position | Mary Rosener (MARRIAGE & FAMILY THERAPIST) |
| Authorized Official Contact | 6127071504 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Body Wise Mind, Llc 491 Arlington Ave W Saint Paul MN 55117-3501 Ph: (612) 707-1504 | Wise Body Wise Mind, Llc 38868 12th Ave # 1032 North Branch MN 55056-6658 Ph: (612) 707-1504 |
| NPI Number | 1164130142 |
|---|---|
| Provider Enumeration Date | 11/09/2022 |
| Last Update Date | 11/09/2022 |
| Certification Date | 11/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164130142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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