Organization
AGAPE COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRA JEAN HECKENLAIBLE-GOTTO LP (LICENSED PSYCHOLOGIST)
(507) 822-3177
Entity
Organization
Contact information
Practice address
305 9TH ST, WINDOM, MN 56101-1658
(507) 832-8033
(507) 832-8298
Mailing address
PO BOX 293, WINDOM, MN 56101-0293
(507) 832-8033
(507) 832-8298
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
MN
103T00000X
Psychologist
Primary
4507
MN
Other
Enumeration date
02/06/2010
Last updated
02/06/2010
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