| Olistica, Inc. | |
|
1405 Silver Lake Rd Nw Ste 17 New Brighton MN 55112-9309 | |
| (763) 300-9829 | |
| (612) 814-0671 |
| Full Name | Olistica, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1405 Silver Lake Rd Nw Ste 17, New Brighton, Minnesota |
| Authorized Official Name and Position | Kathy A Dixon (FOUNDER/COUNSELOR) |
| Authorized Official Contact | 7633009829 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Olistica, Inc. 1405 Silver Lake Rd Nw Ste 17 New Brighton MN 55112-9309 Ph: (763) 300-9829 | Olistica, Inc. 1405 Silver Lake Rd Nw Ste 17 New Brighton MN 55112-9309 Ph: (763) 300-9829 |
| NPI Number | 1174179998 |
|---|---|
| Provider Enumeration Date | 08/16/2019 |
| Last Update Date | 08/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174179998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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