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General NPI Number Information
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NPI Number | 1205025442
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Entity Type | Organization
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Legal Business Name | TRUE BALANCE LTD
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 16016 233RD ST
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City | LITTLE FALLS
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State | MN
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Zip | 56345-5583
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Country | US
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Telephone | 320-632-5524
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Fax | 888-991-2741
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Provider Business Mailing Address
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Address Line | 16016 233RD ST
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City | LITTLE FALLS
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State | MN
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Zip | 56345-5583
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Country | US
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Telephone | 320-632-5524
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Fax | 888-991-2741
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Authorized Official
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Title or Position | OWNER
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Name | DR. LESLIE ANN RUSSELL-MARTIN
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Credential | MS LMFT PHD LP
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Telephone | 218-831-1871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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