Organization
EQUILIBRIYA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY LEE MCMAHON LMFT, LADC, CST (CO-OWNER)
(651) 342-2175
Entity
Organization
Contact information
Practice address
105 NEW ENGLAND PL STE 150, STILLWATER, MN 55082-2036
(651) 342-2175
Mailing address
105 NEW ENGLAND PL STE 150, STILLWATER, MN 55082-2036
(651) 342-2175
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
3313
MN
101Y00000X
Counselor
Primary
81
MN
101YA0400X
Addiction (Substance Use Disorder) Counselor
303560
MN
106H00000X
Marriage & Family Therapist
3313
MN
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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