Organization
ANEW HEALTH AND WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAELENE COLESTOCK LPCC, LADC (EXECUTIVE DIRECTOR)
(651) 402-4055
Entity
Organization
Contact information
Practice address
445 ETNA ST STE 55, SAINT PAUL, MN 55106-5848
(651) 756-8561
(651) 493-7057
Mailing address
445 ETNA ST STE 55, SAINT PAUL, MN 55106-5848
(651) 756-8561
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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