Provider Demographics
NPI:1225427701
Name:O'BRIEN, FELICIA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6949 VALLEY CREEK RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2253
Mailing Address - Country:US
Mailing Address - Phone:651-775-9804
Mailing Address - Fax:651-212-4884
Practice Address - Street 1:6949 VALLEY CREEK RD
Practice Address - Street 2:SUITE 220
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2253
Practice Address - Country:US
Practice Address - Phone:651-775-9804
Practice Address - Fax:651-212-4884
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2935106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist