Individual
MANA VUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
23 EMPIRE DR, SUITE 105, SAINT PAUL, MN 55103-1856
(651) 343-5929
(651) 458-5255
Mailing address
23 EMPIRE DR, SUITE 105, SAINT PAUL, MN 55103-1856
(651) 343-5929
(651) 458-5255
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1470
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136506
UCARE
MN
01
—
160G9VU
BLUE CROSS BLUE SHIELD OF MN
MN
05
—
542473900
—
MN
01
—
6246883
MEDICA
MN
01
—
HP52401
HEALTH PARTNERS
MN
Enumeration date
01/16/2007
Last updated
11/09/2009
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