Organization
GRANITE CITY COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHAD MICHAEL BOSL L.M.F.T. (CLINICAL DIRECTOR)
(320) 257-1800
Entity
Organization
Contact information
Practice address
250 7TH AVE N, WAITE PARK, MN 56387-1152
(320) 257-1800
(320) 257-1801
Mailing address
250 7TH AVE N, WAITE PARK, MN 56387-1152
(320) 257-1800
(320) 257-1801
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2823
MN
Other
Enumeration date
02/15/2008
Last updated
10/28/2020
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