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General NPI Number Information
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NPI Number | 1477222115
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Entity Type | Organization
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Legal Business Name | SEEDS OF SERENITY MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 1618 S 4TH ST
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City | SAINT PETER
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State | MN
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Zip | 56082-1537
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Country | US
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Telephone | 507-320-4795
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Fax | 507-218-9977
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Provider Business Mailing Address
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Address Line | 1618 S 4TH ST
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City | SAINT PETER
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State | MN
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Zip | 56082-1537
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Country | US
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Telephone | 507-320-4795
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Fax | 507-218-9977
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Authorized Official
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Title or Position | OWNER AND THERAPIST
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Name | NICOLE GARTNER
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Credential | LMFT
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Telephone | 507-320-4795
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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 |
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License Number State |
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