Organization
SOARING EAGLE THERAPEUTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY RUSSELL HUNTER MA, LMFT (THERAPIST)
(651) 269-0485
Entity
Organization
Contact information
Practice address
2046 SAINT CLAIR AVE, SAINT PAUL, MN 55105-1650
(651) 269-0485
Mailing address
1775 JULIET AVE, SAINT PAUL, MN 55105-2124
(651) 269-0485
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1605
MN
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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