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Individual

CASSIDY HENRIQUES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
201 N BROAD ST STE 200, MANKATO, MN 56001-3569
(507) 200-2624
(507) 225-1501
Mailing address
201 HEATHER LN APT 8, MANKATO, MN 56001-5690
(763) 412-5463

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
119421173902
UT
106H00000X
Marriage & Family Therapist
Primary
4691
MN
106S00000X
Behavior Technician

Other

Enumeration date
07/02/2018
Last updated
12/11/2024
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