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REALIZE MORE: PSYCHOTHERAPY, CONSULTATION, AND COACHING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA L MOORE MSW (OWNER)
(612) 234-1223
Entity
Organization

Contact information

Practice address
2637 27TH AVE S STE 231, MINNEAPOLIS, MN 55406-3196
(503) 528-4033
Mailing address
1304 LIBERTY CT, NORTHFIELD, MN 55057-2915
(503) 528-4033

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
25252
MN

Other

Enumeration date
05/04/2018
Last updated
05/04/2018
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