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General NPI Number Information
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NPI Number | 1932962073
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Entity Type | Organization
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Legal Business Name | TRINITY COUNSELING & CONSULTING PLLC
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Dates
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Enumeration Date | 02/01/2024
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 16892 LIMONITE TER NW
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City | RAMSEY
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State | MN
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Zip | 55303-2361
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Country | US
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Telephone | 612-220-2747
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Fax |
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Provider Business Mailing Address
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Address Line | 16892 LIMONITE TER NW
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City | RAMSEY
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State | MN
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Zip | 55303-2361
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KENAN MASSA OBIKO OMBASA
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Credential | LICSW
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Telephone | 612-220-2747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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