Organization
MINNESOTA STATE UNIVERSITY MOORHEAD
Active
Other names
Community Outreach Center
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN LEE ERIE LPC (CLINIC COORDINATOR)
(218) 477-2506
Entity
Organization
Contact information
Practice address
113 LOMMEN, 1104 7TH AVE S, MOORHEAD, MN 56563-1013
(218) 477-2506
Mailing address
113 LOMMEN, 1104 7TH AVE S, MOORHEAD, MN 56563-1013
(218) 477-2506
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
103T00000X
Psychologist
—
—
Other
Enumeration date
07/16/2013
Last updated
07/16/2013
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