# DOCTORS PARK MENTAL HEALTH CENTER, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295121648
- **Authorized official:** BECKY GAYLE COULTER LMFT (SUPERVISOR)
- **Authorized official phone:** (320) 316-0300

## Contact information

- **Practice address:** 103 DOCTORS PARK, SAINT CLOUD, MN 56303-1207
- **Practice address phone:** (320) 316-0300
- **Mailing address:** 103 DOCTORS PARK, SAINT CLOUD, MN 56303-1207
- **Mailing address phone:** (320) 316-0300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 1503 | MN | Yes |

## Other

- **Enumeration date:** 04/13/2015
- **Last updated:** 04/13/2015