Organization
THE WELLNESS LIVING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN L CASHMAN M.A., L.P. (EXECUTIVE DIRECTOR)
(612) 598-3891
Entity
Organization
Contact information
Practice address
10088 199TH ST W, LAKEVILLE, MN 55044-6266
(612) 598-3891
Mailing address
10088 199TH ST W, LAKEVILLE, MN 55044-6266
(612) 598-3891
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0089
MN
Other
Enumeration date
05/11/2010
Last updated
05/11/2010
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