| Changing Strides Therapy Llc | |
|
10010 Strawberry Lake Rd Pequot Lakes MN 56472-2291 | |
| (218) 833-7636 | |
| (218) 543-4394 |
| Full Name | Changing Strides Therapy Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 10010 Strawberry Lake Rd, Pequot Lakes, Minnesota |
| Authorized Official Name and Position | Stacy Louise Gustafson (COUNSELOR) |
| Authorized Official Contact | 2188337636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing Strides Therapy Llc Po Box 625 Crosslake MN 56442-0625 Ph: (218) 833-7636 | Changing Strides Therapy Llc 10010 Strawberry Lake Rd Pequot Lakes MN 56472-2291 Ph: (218) 833-7636 |
| NPI Number | 1487001400 |
|---|---|
| Provider Enumeration Date | 05/19/2016 |
| Last Update Date | 12/04/2024 |
| Certification Date | 12/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487001400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | CC01066 (Minnesota) | Primary |