Organization
CEDAR BRANCH COUNSELING GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELIZABETH CLARK LMFT (PLLC MEMBER, FAMILY THERAPIST)
(218) 240-0368
Entity
Organization
Contact information
Practice address
2232 2ND AVE E STE 5, INTERNATIONAL FALLS, MN 56649-4042
(218) 319-7171
(218) 260-4749
Mailing address
2232 2ND AVE E STE 5, INTERNATIONAL FALLS, MN 56649-4042
(218) 319-7171
(218) 260-4749
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1267
MN
101YP2500X
Professional Counselor
1576
MN
106H00000X
Marriage & Family Therapist
Primary
3298
MN
106H00000X
Marriage & Family Therapist
3507
MN
106H00000X
Marriage & Family Therapist
3514
MN
Other
Enumeration date
05/10/2018
Last updated
10/13/2023
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