| Therapy Place Services Llc | |
|
10800 Lyndale Ave S Ste 179 Bloomington MN 55420-5687 | |
| (952) 380-8515 | |
| (952) 314-1356 |
| Full Name | Therapy Place Services Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 10800 Lyndale Ave S Ste 179, Bloomington, Minnesota |
| Authorized Official Name and Position | Jan Louise Weber (OWNER) |
| Authorized Official Contact | 9523808515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Place Services Llc 10800 Lyndale Ave S Ste 179 Bloomington MN 55420-5687 Ph: (952) 380-8515 | Therapy Place Services Llc 10800 Lyndale Ave S Ste 179 Bloomington MN 55420-5687 Ph: (952) 380-8515 |
| NPI Number | 1538462098 |
|---|---|
| Provider Enumeration Date | 12/06/2010 |
| Last Update Date | 12/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538462098 | NPI | - | NPPES |
| 567422100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 12164 (Minnesota) | Primary |
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