Provider Demographics
NPI:1275124117
Name:BRYANS, ONDREA LEE (MS LMFT)
Entity Type:Individual
Prefix:
First Name:ONDREA
Middle Name:LEE
Last Name:BRYANS
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:ONDREA
Other - Middle Name:LEE
Other - Last Name:OXBORROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1875 STATION PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-3319
Mailing Address - Country:US
Mailing Address - Phone:763-482-9598
Mailing Address - Fax:612-235-6447
Practice Address - Street 1:18205 45TH AVE N STE D
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-4594
Practice Address - Country:US
Practice Address - Phone:763-482-9598
Practice Address - Fax:612-235-6447
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4518106H00000X
WI2036-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist