Organization
EVOLVE HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BLONDELL LMFT (OWNER/THERAPIST)
(612) 245-8661
Entity
Organization
Contact information
Practice address
5821 CEDAR LAKE RD S, SUITE 8, ST LOUIS PARK, MN 55416-1487
(612) 245-8661
Mailing address
5821 CEDAR LAKE RD S, SUITE 8, ST LOUIS PARK, MN 55416-1487
(612) 245-8661
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1658
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699923359
—
MN
Enumeration date
11/19/2016
Last updated
11/19/2016
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