# SILVER BIRCH THERAPY PLLC

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

## Provider details

- **NPI number:** 1659878742
- **Authorized official:** AMY VREDENBURGH MA, LMFT (OWNER)
- **Authorized official phone:** (612) 876-6586

## Contact information

- **Practice address:** 905 STANLEY AVE, CLOQUET, MN 55720-3186
- **Practice address phone:** (612) 876-6586
- **Practice address fax:** (185) 851-5862
- **Mailing address:** 9450 SW GEMINI DR, PMB 14034, BEAVERTON, OR 97008-5842
- **Mailing address phone:** (612) 876-6586

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 2962 | MN | Yes |

## Other

- **Enumeration date:** 04/06/2018
- **Last updated:** 06/02/2021