Organization
WILD ACRES COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY LYN BOISJOLI MA, LPCC (OWNER / PRESIDENT)
(651) 315-5254
Entity
Organization
Contact information
Practice address
15489 45TH ST S, ALTON, MN 55001
(651) 315-5254
Mailing address
15489 45TH ST S, ALTON, MN 55001
(651) 315-5254
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1286
MN
Other
Enumeration date
10/11/2014
Last updated
06/17/2020
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