Organization
SPEAK EASY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA KAY REYNOLDS WEIDENDORF LPCC (OWNER)
(218) 245-5073
Entity
Organization
Contact information
Practice address
10 NW 5TH ST STE 203, GRAND RAPIDS, MN 55744-2660
(218) 245-5073
Mailing address
10 NW 5TH ST STE 203, GRAND RAPIDS, MN 55744-2660
(218) 245-5073
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619484862
NPI 1
—
Enumeration date
03/23/2019
Last updated
03/23/2019
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