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Organization

ENTWINE II LLC

Active
Other names
Entwine II, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
LISA JOYCE KELLER SALVAGGIO PSY.D. (OWNER)
(701) 720-7222
Entity
Organization

Contact information

Practice address
3505 8TH ST S STE 3, MOORHEAD, MN 56560-5108
(701) 532-0991
(701) 532-0428
Mailing address
3615 17TH ST S, MOORHEAD, MN 56560-7050
(701) 720-7222
(701) 532-0428

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Enumeration date
02/08/2023
Last updated
10/21/2024
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