# MINNETONKA PSYCHOLOGY AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Minnesota Relationship Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417204751
- **Authorized official:** DR. ROGER A. BALLOU PHD (CO-OWNER)
- **Authorized official phone:** (952) 767-0442

## Contact information

- **Practice address:** 19765 HIGHWAY 7, SUITE 203, SHOREWOOD, MN 55331
- **Practice address phone:** (952) 767-0442
- **Practice address fax:** (952) 854-1647
- **Mailing address:** 19765 HIGHWAY 7, SUITE 203, SHOREWOOD, MN 55331
- **Mailing address phone:** (952) 767-0442
- **Mailing address fax:** (952) 854-1647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 1130 | MN | Yes |

## Other

- **Enumeration date:** 08/06/2012
- **Last updated:** 07/10/2014