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Organization
THERAPY PLACE SERVICES LLC
Active
Organization
THERAPY PLACE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN LOUISE WEBER MSW LICSW (OWNER)
(952) 380-8515
Entity
Organization
Contact information
Practice address
10800 LYNDALE AVE S STE 179, BLOOMINGTON, MN 55420-5687
(952) 380-8515
(952) 314-1356
Mailing address
10800 LYNDALE AVE S STE 179, BLOOMINGTON, MN 55420-5687
(952) 380-8515
(952) 314-1356
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12164
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
567422100
—
MN
Enumeration date
12/06/2010
Last updated
12/06/2010
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