Organization
MIND.BODY.SELF., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARA MERRILL LICSW (CLINICAL SOCIAL WORKER)
(612) 710-6107
Entity
Organization
Contact information
Practice address
4749 CHICAGO AVE STE 2B, MINNEAPOLIS, MN 55407-3561
(612) 710-6107
Mailing address
4749 CHICAGO AVE STE 2B, MINNEAPOLIS, MN 55407-3561
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
14777
MN
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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