Organization
LIFE CHOICES COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD ILLSLEY PAGENKOPF JR. (OFFICE MANAGER)
(218) 937-5569
Entity
Organization
Contact information
Practice address
900 HIGHWAY 34 E, SUITE B102, DETROIT LAKES, MN 56501-2643
(218) 937-5569
Mailing address
900 HIGHWAY 34 E, SUITE B103, DETROIT LAKES, MN 56501-2643
(218) 937-5569
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/29/2010
Last updated
01/29/2010
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