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Organization
WILDFLOWER THERAPY SERVICES
Active
Organization
WILDFLOWER THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MAGNUSON (OWNER)
(763) 200-1215
Entity
Organization
Contact information
Practice address
13750 CROSSTOWN DR NW STE 102, ANDOVER, MN 55304-5855
(763) 200-1215
Mailing address
13750 CROSSTOWN DR NW STE 102, ANDOVER, MN 55304-5855
(763) 200-1215
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
03/10/2023
Last updated
08/29/2024
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