Organization
LIVWELL THERAPY & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISE SMITH (CREDENTIALING SPECIALIST)
(952) 213-4114
Entity
Organization
Contact information
Practice address
213 74TH WAY N, BROOKLYN PARK, MN 55444-3001
(612) 456-1036
(952) 213-4117
Mailing address
7501 W 101ST ST APT 114, BLOOMINGTON, MN 55438-2519
(952) 213-4114
(952) 213-4117
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/07/2023
Last updated
04/07/2023
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