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General NPI Number Information
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NPI Number | 1528455045
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Entity Type | Organization
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Legal Business Name | SISU RELATIONAL SERVICES
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 11/15/2018
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Provider Practice Location Address
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Address Line | 410 E 48TH ST STE 5
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City | MINNEAPOLIS
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State | MN
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Zip | 55419-5651
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Country | US
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Telephone | 612-801-1525
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Fax |
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Provider Business Mailing Address
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Address Line | 5933 THOMAS AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55410-2956
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Country | US
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Telephone | 612-801-1525
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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 | MRS. STACY ORFIELD SAINDON
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Credential | L.M.F.T
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Telephone | 612-801-1525
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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 | 1070
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License Number State | MN
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