Organization
KIND WATERS THERAPY & WELLNESS. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISE AILEEN SMITH (HIPAA CREDENTIALING SPECIALIST)
(952) 213-4114
Entity
Organization
Contact information
Practice address
3557 33 AVE S, MINNEAPOLIS, MN 55406
(612) 599-9488
(952) 213-4117
Mailing address
3557 33 AVE S, MINNEAPOLIS, MN 55406
(612) 599-9488
(952) 213-4117
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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