Individual
MELODIE ILLIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16201 90TH ST NE, SUITE 200, OTSEGO, MN 55330-7463
(763) 746-9492
Mailing address
1900 SILVER LAKE RD NW, SUITE110, NEW BRIGHTON, MN 55112-1786
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2447
MN
Other
Enumeration date
05/30/2012
Last updated
05/30/2012
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