Individual
AMENTI THEOPHILOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20855 KENSINGTON BLVD, LAKEVILLE, MN 55044-7542
(507) 291-2662
(507) 205-2885
Mailing address
600 E 131ST ST, BURNSVILLE, MN 55337-3804
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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