Individual
MICHAEL BOUSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LMFT
Contact information
Practice address
220 RAILROAD ST SE, PINE CITY, MN 55063-1540
(320) 629-7600
Mailing address
220 RAILROAD ST SE, PINE CITY, MN 55063-1540
(320) 629-7600
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4035
MN
Other
Enumeration date
09/06/2022
Last updated
09/08/2022
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