Organization
CHANGE INC.
Active
Other names
Guadalupe Alternative Programs
Organization subpart
No
Provider details
NPI number
Authorized official
JODY NELSON EDD, LMFT (EXECUTIVE DIRECTOR)
(651) 222-0757
Entity
Organization
Contact information
Practice address
381 ROBIE ST E, SAINT PAUL, MN 55107-2415
(651) 222-0757
Mailing address
381 ROBIE ST E, SAINT PAUL, MN 55107-2415
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
690947700
—
MN
Enumeration date
02/13/2007
Last updated
05/26/2020
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