Organization
FAMILY LIFESTYLES, COUNSELING & THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN H. BLONIGEN M.A., L.P (PRESIDENT)
(612) 716-7159
Entity
Organization
Contact information
Practice address
5100 THIMSEN AVE, SUITE 130, MINNETONKA, MN 55345-4108
(612) 716-7159
(952) 474-4025
Mailing address
5100 THIMSEN AVE, SUITE 130, MINNETONKA, MN 55345-4108
(612) 716-7159
(952) 474-4025
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 3981
MN
Other
Enumeration date
02/24/2010
Last updated
02/24/2010
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