Organization
DIVERGENT PATH THERAPY PLLC
Active
Organization
DIVERGENT PATH THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE PRIJATEL-SPARE (OWNER)
(612) 217-4890
Entity
Organization
Contact information
Practice address
4404 NICOLLET AVE APT 1, MINNEAPOLIS, MN 55419-2642
(612) 217-4890
Mailing address
4404 NICOLLET AVE APT 1, MINNEAPOLIS, MN 55419-2642
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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