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General NPI Number Information
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NPI Number | 1811368723
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Entity Type | Organization
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Legal Business Name | BUDDING LOTUS TRANSFORMATIONS, LLC
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 7800 METRO PKWY SUITE 300
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1514
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Country | US
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Telephone | 952-767-4995
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Fax | 952-777-1657
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Provider Business Mailing Address
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Address Line | 7800 METRO PKWY SUITE 300
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1514
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Country | US
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Telephone | 952-767-4995
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Fax | 952-777-1657
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Authorized Official
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Title or Position | OWNER
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Name | SHERRI M DUNHAM
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Credential | MA, LPC
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Telephone | 952-767-4995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 1431
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License Number State | MN
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