Organization
DOCTORS PARK MENTAL HEALTH CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY GAYLE COULTER LMFT (SUPERVISOR)
(320) 316-0300
Entity
Organization
Contact information
Practice address
103 DOCTORS PARK, SAINT CLOUD, MN 56303-1207
(320) 316-0300
Mailing address
103 DOCTORS PARK, SAINT CLOUD, MN 56303-1207
(320) 316-0300
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1503
MN
Other
Enumeration date
04/13/2015
Last updated
04/13/2015
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