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General NPI Number Information
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NPI Number | 1174442636
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Entity Type | Organization
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Legal Business Name | BOTH& COUNSELING PLLC
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 7600 PARKLAWN AVE STE 110
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City | EDINA
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State | MN
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Zip | 55435-5125
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Country | US
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Telephone | 952-955-4714
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Fax |
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Provider Business Mailing Address
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Address Line | 7600 PARKLAWN AVE STE 110
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City | EDINA
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State | MN
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Zip | 55435-5125
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MELISSA LARSON
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Credential | LICSW
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Telephone | 507-236-3186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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