Life Roads, LLC
NPI #1609091008 in Forest Lake, Minnesota
Provider Information
- NPI Number
- 1609091008
- Entity Type
- Organization
- Organization Name
- Life Roads, LLC
- Primary Specialty
- Marriage & Family Therapist
- Enumeration Date
- Apr 13, 2007
- Last Updated
- Oct 24, 2012
Practice Location
- Address
- 1068 LAKE ST S
- Address 2
- SUITE 109
- City
- Forest Lake
- State
- Minnesota
- ZIP Code
- 55025-2639
- Phone
- (651) 230-0492
Authorized Official
- Name
- SHARON ROSE FRIES, LMFT
- Title
- OWNER
- Phone
- (651) 230-0492
Specialties & Taxonomy Codes
| Specialty |
|---|
| Marriage & Family Therapist |
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