| Willow Tree Wellness, Inc | |
|
4423 Viking Blvd Ne East Bethel MN 55092-9494 | |
| (651) 216-5309 | |
| Not Available |
| Full Name | Willow Tree Wellness, Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4423 Viking Blvd Ne, East Bethel, Minnesota |
| Authorized Official Name and Position | Amanda L Pikala (OWNER) |
| Authorized Official Contact | 6512165309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Tree Wellness, Inc 4423 Viking Blvd Ne East Bethel MN 55092-9494 Ph: (651) 216-5309 | Willow Tree Wellness, Inc 4423 Viking Blvd Ne East Bethel MN 55092-9494 Ph: (651) 216-5309 |
| NPI Number | 1245848696 |
|---|---|
| Provider Enumeration Date | 07/21/2020 |
| Last Update Date | 07/21/2020 |
| Certification Date | 07/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245848696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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