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General NPI Number Information
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NPI Number | 1356910475
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Entity Type | Organization
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Legal Business Name | NURTURE WOMEN'S THERAPY, LLC
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 1103 BROADWAY ST STE 102
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City | ALEXANDRIA
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State | MN
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Zip | 56308-0015
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Country | US
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Telephone | 320-238-9119
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Fax | 320-238-7920
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Provider Business Mailing Address
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Address Line | 1103 BROADWAY ST STE 102
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City | ALEXANDRIA
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State | MN
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Zip | 56308-0015
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Country | US
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Telephone | 320-238-9119
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY ELAINE SWART
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Credential | MSW, LICSW, PMH-C
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Telephone | 320-238-9119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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