| Enrichment Therapy Services | |
|
2115 Kimball Ave Nw Annandale MN 55302-3229 | |
| (651) 301-8023 | |
| (612) 446-5778 |
| Full Name | Enrichment Therapy Services |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2115 Kimball Ave Nw, Annandale, Minnesota |
| Authorized Official Name and Position | Traci Emmick (OWNER/OPERATOR) |
| Authorized Official Contact | 6514421901 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enrichment Therapy Services Po Box 132 Farmington MN 55024-0132 Ph: () - | Enrichment Therapy Services 2115 Kimball Ave Nw Annandale MN 55302-3229 Ph: (651) 301-8023 |
| NPI Number | 1760264212 |
|---|---|
| Provider Enumeration Date | 10/19/2023 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760264212 | NPI | - | NPPES |
| 195283841 | Medicaid | MN | |
| 3487 | Other | MN | MARRIAGE AND FAMILY THERAPY LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Room To Grow Therapy And Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 64 Oak Ave S, Annandale, MN 55302 Phone: 320-281-6800 |