NPI 1104660489

Mya Marie Badillo

Practitioner Mental Health Counselor Prior Lake, MN

Practice location

Address: 3733 Fox Tail Trl NW, Prior Lake, MN 55372-1698
Phone: (612) 438-9204

Registered specialties

Mental Health Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YM0800X

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Registry record

NPI: 1104660489
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Jun 2024
Record last updated: 21 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.