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Organization
VIDA SANA THERAPY LLC
Active
Organization
VIDA SANA THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MARIA VANDYKE MSW, LICSW (THERAPIST)
(612) 759-9529
Entity
Organization
Contact information
Practice address
7300 147TH ST W STE 302, APPLE VALLEY, MN 55124-7541
(612) 759-9529
Mailing address
7300 147TH ST W STE 302, APPLE VALLEY, MN 55124-7541
(612) 759-9529
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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