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Organization
MOVING MOUNTAINS LLC
Active
Organization
MOVING MOUNTAINS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI K BRUDER LICSW (OWNER)
(480) 431-1589
Entity
Organization
Contact information
Practice address
415 LAKE SHORE DR NE APT 104, BEMIDJI, MN 56601-4682
(480) 431-1589
Mailing address
415 LAKE SHORE DR NE APT 104, BEMIDJI, MN 56601-4682
(480) 431-1589
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/31/2021
Last updated
07/31/2021
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