Individual
TARA BETHANY ELIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
411 3RD ST SE, OSSEO, MN 55369-1606
(763) 951-3091
(763) 951-3097
Mailing address
11141 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
(763) 951-3091
(763) 951-3097
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4210
MN
Other
Enumeration date
02/25/2014
Last updated
03/28/2024
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