Organization
MN COUPLE THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KURT A WICAL PHD (DIRECTOR)
(651) 340-4597
Entity
Organization
Contact information
Practice address
1611 COUNTY ROAD B W, SUITE 303, ROSEVILLE, MN 55113-5021
(651) 340-4597
(651) 340-4597
Mailing address
1611 COUNTY ROAD B W, SUITE 303, ROSEVILLE, MN 55113-5021
(651) 340-4597
(651) 340-4597
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1357
MN
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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