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General NPI Number Information
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NPI Number | 1922320142
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Entity Type | Individual
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Provider Name | MICHAEL DAVID FLATEN LMFT
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Gender | Male
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 100 17TH AVE NW SUITE #2 LAKELAND MENTAL HEALTH CENTER
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City | GLENWOOD
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State | MN
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Zip | 56334
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Country | US
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Telephone | 320-634-3446
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Fax | 320-634-0384
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Provider Business Mailing Address
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Address Line | 1593 HIDDEN VALLEY LANE NW
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City | MILTONA
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State | MN
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Zip | 56354
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Country | US
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Telephone | 612-655-0193
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2014
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License Number State | MN
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