Organization
TANGLEFISH EMOTIONAL HEALING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA E GREY MSW LICSW (OWNER)
(612) 213-4510
Entity
Organization
Contact information
Practice address
821 RAYMOND AVE STE 300, SAINT PAUL, MN 55114-1525
(612) 213-4510
(612) 361-5464
Mailing address
821 RAYMOND AVE STE 300, SAINT PAUL, MN 55114-1525
(612) 213-4510
(612) 361-5464
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982258125
NPI 1
MN
Enumeration date
05/28/2022
Last updated
03/06/2024
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