Behavioral Wellness Counseling Clinic, LLC
NPI #1033545439 in Prior Lake, Minnesota
Provider Information
- NPI Number
- 1033545439
- Entity Type
- Organization
- Organization Name
- Behavioral Wellness Counseling Clinic, LLC
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Sep 18, 2013
- Last Updated
- Sep 18, 2013
Practice Location
- Address
- 14093 COMMERCE AVE NE
- City
- Prior Lake
- State
- Minnesota
- ZIP Code
- 55372-1495
- Phone
- (952) 440-3100
Authorized Official
- Name
- MS. TRACY LEE KLING KOTVAL, MA. LPCC
- Title
- DIRECTOR
- Phone
- (952) 440-3100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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