# WILD ACRES COUNSELING, LLC

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

## Provider details

- **NPI number:** 1346644952
- **Authorized official:** MRS. KATHY LYN BOISJOLI MA, LPCC (OWNER / PRESIDENT)
- **Authorized official phone:** (651) 315-5254

## Contact information

- **Practice address:** 15489 45TH ST S, ALTON, MN 55001
- **Practice address phone:** (651) 315-5254
- **Mailing address:** 15489 45TH ST S, ALTON, MN 55001
- **Mailing address phone:** (651) 315-5254

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 1286 | MN | Yes |

## Other

- **Enumeration date:** 10/11/2014
- **Last updated:** 06/17/2020