Healthcare Provider Details

I. General information

NPI: 1043325863
Provider Name (Legal Business Name): DOROTHY A ELION LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8530 EAGLE POINT BLVD STE 150
LAKE ELMO MN
55042-8654
US

IV. Provider business mailing address

2550 UNIVERSITY AVE W STE 435S
SAINT PAUL MN
55114-1907
US

V. Phone/Fax

Practice location:
  • Phone: 651-264-0402
  • Fax: 651-738-8214
Mailing address:
  • Phone: 651-647-1900
  • Fax: 651-647-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number806
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: