Individual
MALLORY WOLFGRAMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13700 83RD WAY N, #201, MAPLE GROVE, MN 55369
(763) 400-7475
Mailing address
2817 GIRARD AVE S APT 412, MINNEAPOLIS, MN 55408-5028
(847) 899-1173
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
3614
MN
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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