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Organization
WILLOW TREE HEALING CENTER, LLC
Active
Organization
WILLOW TREE HEALING CENTER, LLC
Active
Other names
Tracey Wilkins, LICSW, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY WILKINS LICSW (CLINICAL SERVICES DIRECTOR)
(651) 222-9985
Entity
Organization
Contact information
Practice address
1821 UNIVERSITY AVE W, SUITE S329, SAINT PAUL, MN 55104-2801
(651) 222-9885
(888) 977-2056
Mailing address
1821 UNIVERSITY AVE, SUITE S329, ST PAUL, MN 55104
(651) 222-9885
(888) 977-2056
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13119
MN
1041C0700X
Clinical Social Worker
15043
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312174700
—
MN
Enumeration date
03/31/2009
Last updated
02/19/2015
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