Individual
LEAH MARJORIE MCELLISTREM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1123 GRAND AVE APT 203, SAINT PAUL, MN 55105-2744
(651) 352-7105
Mailing address
1123 GRAND AVE APT 203, SAINT PAUL, MN 55105-2744
(651) 352-7105
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
3289
MN
Other
Enumeration date
11/05/2015
Last updated
05/01/2018
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