| Authentic Roots Therapy Pllc | |
|
7077 Northland Cir N Ste 330 Minneapolis MN 55428-1567 | |
| (612) 799-6652 | |
| Not Available |
| Full Name | Authentic Roots Therapy Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 7077 Northland Cir N Ste 330, Minneapolis, Minnesota |
| Authorized Official Name and Position | Amanda Wirth (CEO) |
| Authorized Official Contact | 6127996652 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Roots Therapy Pllc 11711 55th St Ne Albertville MN 55301-9745 Ph: (612) 799-6652 | Authentic Roots Therapy Pllc 7077 Northland Cir N Ste 330 Minneapolis MN 55428-1567 Ph: (612) 799-6652 |
| NPI Number | 1346822046 |
|---|---|
| Provider Enumeration Date | 04/22/2021 |
| Last Update Date | 08/10/2021 |
| Certification Date | 08/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346822046 | NPI | - | NPPES |
| 7416210 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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