Organization
HEARTFELT THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI LYN WEISE LICSW (OWNER)
(612) 280-3048
Entity
Organization
Contact information
Practice address
17439 ISLETON AVE, LAKEVILLE, MN 55044-9693
(612) 280-3048
Mailing address
17439 ISLETON AVE, LAKEVILLE, MN 55044-9693
(612) 280-3048
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
15625
MN
Other
Enumeration date
11/02/2015
Last updated
11/02/2015
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