Porsche Peak, LMFT, LADC
Marriage & Family Therapist in Little Canada, MN. Individual provider (NPI-1).
NPI number1669927273
StatusActive
Last updated in NPPESMar 25, 2019
Details
- NPI
- 1669927273
- Entity type
- Individual (NPI-1)
- Name
- Porsche Peak
- Credential
- LMFT, LADC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 24, 2016
- Last updated
- Mar 25, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 3415 | MN | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 304885 | MN | |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
2864 Middle St Ste 100Little Canada, MN 55117-1411
Phone 651-493-2055 · Fax 651-340-8632
Mailing address
2864 Middle St Ste 100Little Canada, MN 55117-1411
Phone 651-493-2055 · Fax 651-340-8632
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