Organization
LIFE ON PURPOSE COUNSELING & NEUROFEEDBACK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNIELLE MARIE FLADTEN WHITE LICSW (PRESIDENT/PSYCHOTHERAPIST)
(651) 600-7876
Entity
Organization
Contact information
Practice address
312 COUNTY ROAD D E, LITTLE CANADA, MN 55117-1275
(651) 600-7876
Mailing address
312 COUNTY ROAD D E, LITTLE CANADA, MN 55117-1275
(651) 600-7876
(651) 705-8181
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18463
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942708573
—
MN
Enumeration date
01/29/2018
Last updated
03/25/2018
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