Organization
FAMILY THERAPY & RECOVERY CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON KAYE ONDICH PHD LP (PRESIDENT)
(952) 545-8833
Entity
Organization
Contact information
Practice address
5353 GAMBLE DR, SUITE 108, ST LOUIS PARK, MN 55416-1539
(952) 545-8833
Mailing address
5353 GAMBLE DR, SUITE 108, ST LOUIS PARK, MN 55416-1539
(952) 545-8833
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1366
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121015
MN CARE
MN
01
—
7H008FA
BCBSIMN
MN
Enumeration date
08/19/2006
Last updated
08/22/2020
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