Organization
MAPLE GROVE THERAPY AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY JO WESNER MSW, LICSW (OWNER, PSYCHOTHERAPIST)
(763) 200-1466
Entity
Organization
Contact information
Practice address
7200 FORESTVIEW LN N, MAPLE GROVE, MN 55369-5571
(763) 200-1466
Mailing address
7200 FORESTVIEW LN N, MAPLE GROVE, MN 55369-5571
(763) 200-1466
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17743
MN
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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