Organization
AWE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIE WHITEAKER (PART OWNER)
(612) 361-6504
Entity
Organization
Contact information
Practice address
4470 W 78TH STREET CIR, BLOOMINGTON, MN 55435-5408
(612) 208-6204
Mailing address
5844 OAKLAWN AVE, EDINA, MN 55424-1918
(319) 360-5768
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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