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Organization

MED CITY PSYCHOTHERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATELYN ALESHIRE OLGREN LICSW (OWNER)
(507) 990-2396
Entity
Organization

Contact information

Practice address
3265 19TH ST NW STE 310, ROCHESTER, MN 55901-6786
(507) 990-2396
Mailing address
1006 9TH AVE SE, ROCHESTER, MN 55904-5073
(507) 990-2396

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P-136-115-670-910
DRIVER'S LICENSE
MN
Enumeration date
02/20/2023
Last updated
01/09/2024
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