Organization
INTERPRETIVE LEADERSHIP INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY SWENSON (LPCC)
(763) 260-8434
Entity
Organization
Contact information
Practice address
13750 CROSSTOWN DR NW STE 207, ANDOVER, MN 55304-5856
(763) 260-8434
Mailing address
13750 CROSSTOWN DR NW STE 207, ANDOVER, MN 55304-5856
(763) 260-8434
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
304034
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
304034
LICENSED DRUG AND ALCOHOL COUNSELOR
MN
Enumeration date
11/21/2016
Last updated
11/21/2016
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