| Glacier Lakes Therapy | |
|
2313 6th Ave Se Willmar MN 56201-4885 | |
| (612) 963-5889 | |
| Not Available |
| Full Name | Glacier Lakes Therapy |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2313 6th Ave Se, Willmar, Minnesota |
| Authorized Official Name and Position | Patrick J Lindstrom (BILLING & CODING SPECIALIST) |
| Authorized Official Contact | 1612963588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glacier Lakes Therapy 2313 6th Ave Se Willmar MN 56201-4885 Ph: (612) 963-5889 | Glacier Lakes Therapy 2313 6th Ave Se Willmar MN 56201-4885 Ph: (612) 963-5889 |
| NPI Number | 1174229223 |
|---|---|
| Provider Enumeration Date | 01/31/2023 |
| Last Update Date | 05/19/2023 |
| Certification Date | 05/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174229223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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