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INTROSPECTIVE PSYCHOTHERAPIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BHARGAVI S GHATE LICSW (OWNER/ PSYCHOTHERAPIST)
(612) 396-6737
Entity
Organization

Contact information

Practice address
5407 EXCELSIOR BLVD, SUITE A, ST LOUIS PARK, MN 55416-2929
(612) 396-6737
Mailing address
5407 EXCELSIOR BOULEVARD, SUITE A, ST. LOUIS PARK, MN 55416

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13697
MN

Other

Enumeration date
02/04/2011
Last updated
02/04/2011
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