Melodie Illies

NPI #1952662611 in Otsego, Minnesota

Provider Information

NPI Number: 1952662611
Entity Type: Individual
Name: Melodie Illies
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Marriage & Family Therapist
Enumeration Date: May 30, 2012
Last Updated: May 30, 2012

Practice Location

Address: 16201 90TH ST NE
Address 2: SUITE 200
City: Otsego
State: Minnesota
ZIP Code: 55330-7463
Phone: (763) 746-9492

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Marriage & Family Therapist	106H00000X	Primary

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