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General NPI Number Information
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NPI Number | 1558048959
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Entity Type | Organization
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Legal Business Name | NORTHERN SKIES PSYCHOTHERAPY AND NUTRITION COUNSELING
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 3387 BROWNLOW AVE
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City | ST LOUIS PARK
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State | MN
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Zip | 55426-4271
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Country | US
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Telephone | 612-293-9107
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Fax |
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Provider Business Mailing Address
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Address Line | 4324 AVONDALE RD
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-3517
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Country | US
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Telephone | 612-293-9107
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAREN ALEXANDER
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Credential |
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Telephone | 612-293-9107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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