Healthcare Provider Details

I. General information

NPI: 1679110761
Provider Name (Legal Business Name): ROOM TO GROW THERAPY AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2019
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MAPLE AVE N
ANNANDALE MN
55302-9301
US

IV. Provider business mailing address

40 MAPLE AVE N
ANNANDALE MN
55302-9301
US

V. Phone/Fax

Practice location:
  • Phone: 320-281-6800
  • Fax:
Mailing address:
  • Phone: 320-281-6800
  • Fax: 320-281-6800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: STEVEN LOCHEN
Title or Position: CO-OWNER
Credential:
Phone: 320-281-6800