Individual
JILL MARIE STANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMFT
Contact information
Practice address
1665 UTICA AVE S, SUITE 100, SAINT LOUIS PARK, MN 55416
(952) 541-2500
(952) 541-2539
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
(952) 541-2500
(952) 541-2539
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1535
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
326922000
—
MN
Enumeration date
05/22/2007
Last updated
04/17/2018
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