Organization
MARY ANDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANDERS MA LP (OWNER)
(763) 447-5793
Entity
Organization
Contact information
Practice address
13911 RIDGEDALE DR, SUITE 330, MINNETONKA, MN 55305-1771
(763) 447-5793
Mailing address
13911 RIDGEDALE DR, SUITE 330, MINNETONKA, MN 55305-1771
(763) 447-5793
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LP3976
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
857725100
—
MN
Enumeration date
06/16/2010
Last updated
06/16/2010
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