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Individual

KAROLYN DILLER MENGERSHAUSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, LMFT

Contact information

Practice address
760 SOUTHCROSS DRIVE WEST, SUITE 103, BURNSVILLE, MN 55306
(952) 835-5088
(952) 835-5088
Mailing address
760 SOUTHCROSS DRIVE WEST, SUITE 103, BURNSVILLE, MN 55306
(952) 835-5088
(952) 835-5088

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
C1147
OR
106H00000X
Marriage & Family Therapist
Primary
1219
MN
106H00000X
Marriage & Family Therapist
T0395
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
976487900
MN
Enumeration date
07/13/2006
Last updated
03/25/2015
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