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Organization
MOMENTA MENTAL HEALTH
Active
Organization
MOMENTA MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIANNE M MARION PSYD (OWNER)
(651) 381-6611
Entity
Organization
Contact information
Practice address
2179 4TH ST STE 2F, WHITE BEAR LAKE, MN 55110-3041
(701) 426-8833
Mailing address
1060 HILLVALE AVE N, OAKDALE, MN 55128-5859
(651) 381-6611
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053785691
—
MN
Enumeration date
11/01/2021
Last updated
01/13/2022
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