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General NPI Number Information
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NPI Number | 1043670326
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Entity Type | Organization
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Legal Business Name | BEING WHILE BECOMING, LLC
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 03/01/2016
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Provider Practice Location Address
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Address Line | 20 W MAIN ST SUITE 200
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City | WACONIA
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State | MN
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Zip | 55387-1020
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Country | US
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Telephone | 952-649-1202
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Fax |
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Provider Business Mailing Address
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Address Line | 20 W MAIN ST SUITE 200
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City | WACONIA
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State | MN
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Zip | 55387-1020
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Country | US
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Telephone | 952-649-1202
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/THERAPIST
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Name | BRITTANY ALTENDORF
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Credential | LMFT
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Telephone | 952-649-1202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2669
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License Number State | MN
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