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General NPI Number Information
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NPI Number | 1518750181
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Entity Type | Organization
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Legal Business Name | AND STILL THERAPY
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 2937 DAKOTA AVE S
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-1834
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Country | US
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Telephone | 701-866-2429
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Fax |
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Provider Business Mailing Address
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Address Line | 2937 DAKOTA AVE S
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-1834
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Country | US
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Telephone | 701-866-2429
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | JOHANNA RAE ERICKSON
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Credential | MA, LMFT
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Telephone | 612-440-0831
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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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