Organization · Type 2 NPI
Indigo Bridge Therapy LLC
Mental Health Clinic/Center (Including Community Mental Health Center) · Eden Prairie, MN
NPI number
1780369843
Active
Practice location
17533 Pavelka Dr
Eden Prairie, MN 55346-4284
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor | 101YP2500X | None listed |
| Marriage & Family Therapist | 106H00000X | None listed |
| Mental Health Clinic/Center (Including Community Mental Health Center) Primary | 261QM0801X | None listed |
| Adult Mental Health Clinic/Center | 261QM0850X | None listed |
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | None listed |
Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...
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About NPI 1780369843
Indigo Bridge Therapy LLC's National Provider Identifier is 1780369843, issued on Jun 16, 2023. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Eden Prairie, MN. The record was last updated on Jun 16, 2023.