| Grow Through Change, Llc | |
|
4 Enterprise Ave Ne Ste 7 Isanti MN 55040-6814 | |
| (763) 200-3411 | |
| Not Available |
| Full Name | Grow Through Change, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4 Enterprise Ave Ne Ste 7, Isanti, Minnesota |
| Authorized Official Name and Position | Robbie Deering (OWNER) |
| Authorized Official Contact | 7632003411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grow Through Change, Llc 4 Enterprise Ave Ne Ste 7 Isanti MN 55040-6814 Ph: (763) 200-3411 | Grow Through Change, Llc 4 Enterprise Ave Ne Ste 7 Isanti MN 55040-6814 Ph: (763) 200-3411 |
| NPI Number | 1134817638 |
|---|---|
| Provider Enumeration Date | 04/24/2023 |
| Last Update Date | 10/12/2023 |
| Certification Date | 10/12/2023 |
| Medicare PECOS PAC ID | 9335585611 |
|---|---|
| Medicare Enrollment ID | O20240308001340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134817638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Robbie Deering |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972088391 PECOS PAC ID: 0244676526 Enrollment ID: I20240308001731 |
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