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General NPI Number Information
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NPI Number | 1356752463
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Entity Type | Organization
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Legal Business Name | YOUR VISION ACHIEVED, LLC
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 1705 SOUTHCROSS DR W UNIT 101
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City | BURNSVILLE
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State | MN
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Zip | 55306-7027
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Country | US
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Telephone | 952-225-1575
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 363
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City | FARMINGTON
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State | MN
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Zip | 55024-0363
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Country | US
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Telephone | 612-269-5313
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. OLGA LIDIA TAPIA-FARRELL
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Credential | LMFT
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Telephone | 612-269-5313
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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 | 1024
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License Number State | MN
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