Individual
MELISSA J FORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
JD, MA, LPCC
Contact information
Practice address
LYNLAKE BUILDING, 621 WEST LAKE STREET, SUITE 350, MINNEAPOLIS, MN 55408
(612) 865-5314
Mailing address
5300 FILLMORE ST NE, FRIDLEY, MN 55421-1305
(612) 865-5314
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4172
MN
Other
Enumeration date
01/03/2023
Last updated
02/25/2024
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