Organization
RADICAL REALNESS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA WRZESINSKI LMFT (OWNER)
(971) 930-0089
Entity
Organization
Contact information
Practice address
510 SW 3RD AVE, SUITE 200, PORTLAND, OR 97204-2543
(971) 930-0089
Mailing address
5131 N LINCOLN AVE STE 1, CHICAGO, IL 60625-2584
(971) 930-0089
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T1159
OR
Other
Enumeration date
06/02/2016
Last updated
02/09/2022
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