Organization
ABC FAMILY COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT N WILSON PHD (PRESIDENT)
(763) 227-8076
Entity
Organization
Contact information
Practice address
229 JACKSON ST, SUITE 136, ANOKA, MN 55303-2254
(763) 227-8076
(763) 421-7892
Mailing address
229 JACKSON ST, SUITE 136, ANOKA, MN 55303-2254
(763) 227-8076
(763) 421-7892
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP-0869
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8L408WI
BCBS CLINIC
MN
Enumeration date
12/23/2006
Last updated
06/09/2014
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