Organization
K.I.D.S.&FAMILY THERAPY,LLC
Active
Organization
K.I.D.S.&FAMILY THERAPY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH K OTTO (ADMINISTRATOR)
(763) 323-8050
Entity
Organization
Contact information
Practice address
11157 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
(763) 710-9949
Mailing address
11157 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
(763) 710-9949
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5822
MN
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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