Healthcare Provider Details

I. General information

NPI: 1285483586
Provider Name (Legal Business Name): WOVEN FAMILY COACHING & COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6571 140TH AVE NE
SPICER MN
56288-8658
US

IV. Provider business mailing address

6571 140TH AVE NE
SPICER MN
56288-8658
US

V. Phone/Fax

Practice location:
  • Phone: 320-295-6470
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. ELIZABETH OLSON
Title or Position: LPCC
Credential: MA
Phone: 320-295-6470