Individual
MARY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2103 B COUNTY ROAD D, MAPLEWOOD, MN 55109
(651) 748-5019
(651) 773-7591
Mailing address
5800 UPPER 183RD ST W, FARMINGTON, MN 55024-8102
(612) 743-0715
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
3779
MN
Other
Enumeration date
05/05/2015
Last updated
07/07/2021
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