Organization
CHANGING LIFESTYLE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARSHA KAY MOLINARI L.I.C.S.W (OWNER)
(952) 542-8751
Entity
Organization
Contact information
Practice address
11900 WAYZATA BLVD STE 116G, MINNETONKA, MN 55305-2018
(952) 542-8751
(952) 582-9395
Mailing address
11900 WAYZATA BLVD STE 116G, MINNETONKA, MN 55305-2018
(952) 542-8751
(952) 582-9395
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
11408
MN
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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