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General NPI Number Information
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NPI Number | 1538866587
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Entity Type | Organization
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Legal Business Name | WHOLE BRAIN HEALING THERAPY
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Dates
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Enumeration Date | 02/10/2023
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 600 TWELVE OAKS CENTER DR STE 642G
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City | WAYZATA
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State | MN
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Zip | 55391-4511
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Country | US
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Telephone | 763-342-2737
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Fax |
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Provider Business Mailing Address
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Address Line | 600 TWELVE OAKS CENTER DR STE 642G
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City | WAYZATA
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State | MN
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Zip | 55391-4511
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Country | US
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Telephone | 763-342-2737
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEGAN BJORKLUND
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Credential | LPCC
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Telephone | 763-342-2737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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