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General NPI Number Information
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NPI Number | 1316643554
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Entity Type | Organization
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Legal Business Name | KNOW THYSELF, PLLC
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Dates
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Enumeration Date | 01/31/2023
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 10505 WAYZATA BLVD STE 203-3
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City | MINNETONKA
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State | MN
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Zip | 55305-1502
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Country | US
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Telephone | 763-242-3261
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Fax | 866-318-3073
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Provider Business Mailing Address
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Address Line | 417 RUCKS FARM RD
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City | DELANO
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State | MN
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Zip | 55328-8837
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Country | US
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Telephone | 763-242-3261
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Fax | 866-318-3073
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELISSA RAATZ
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Credential | LICSW
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Telephone | 763-242-3261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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