Changing Strides Therapy Llc | |
10010 Strawberry Lake Rd Pequot Lakes MN 56472-2291 | |
(218) 543-4394 | |
(218) 543-4394 |
Full Name | Changing Strides Therapy Llc |
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Speciality | Counselor - Mental Health |
Location | 10010 Strawberry Lake Rd, Pequot Lakes, Minnesota |
Authorized Official Name and Position | Stacy Louise Gustafson (COUNSELOR) |
Authorized Official Contact | 2188337636 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Changing Strides Therapy Llc Po Box 625 Crosslake MN 56442-0625 Ph: (218) 543-4394 | Changing Strides Therapy Llc 10010 Strawberry Lake Rd Pequot Lakes MN 56472-2291 Ph: (218) 543-4394 |
NPI Number | 1487001400 |
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Provider Enumeration Date | 05/19/2016 |
Last Update Date | 08/06/2020 |
Certification Date | 08/06/2020 |
Identifier | Type | State | Issuer |
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1487001400 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | CC01066 (Minnesota) | Primary |