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Individual

STACI LEIGH BORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ED.D., LMFT, RPT

Contact information

Practice address
108 WAYNESBOROUGH WAY, MANKATO, MN 56001-6457
(507) 380-0626
Mailing address
108 WAYNESBOROUGH WAY, MANKATO, MN 56001-6457
(507) 380-0626

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
106H00000X
Marriage & Family Therapist
Primary
2566
MN
106H00000X
Marriage & Family Therapist
LMFT1230
SD

Other

Enumeration date
06/29/2013
Last updated
01/13/2022
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