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General NPI Number Information
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NPI Number | 1316426513
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Entity Type | Organization
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Legal Business Name | RESTORING HOPE INDIVIDUAL & FAMILY THERAPY LLC
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 600 25TH AVE S STE 109
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4820
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Country | US
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Telephone | 320-255-0343
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Fax | 320-654-0318
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Provider Business Mailing Address
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Address Line | 600 25TH AVE S STE 109
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City | SAINT CLOUD
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State | MN
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Zip | 56301-4820
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Country | US
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Telephone | 320-255-0343
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | PAMELA L. RIELAND L RIELAND
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Credential | LMFT
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Telephone | 320-255-0343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2444
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License Number State | MN
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