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General NPI Number Information
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NPI Number | 1609423755
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Entity Type | Organization
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Legal Business Name | GUIDING STONE THERAPY AND WELLNESS LLC
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 10501 WAYZATA BLVD STE 204
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City | MINNETONKA
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State | MN
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Zip | 55305-1519
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Country | US
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Telephone | 651-398-2087
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Fax |
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Provider Business Mailing Address
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Address Line | 9641 WASHBURN AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55431-2460
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Country | US
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Telephone | 612-915-0595
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Fax | 651-925-0594
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Authorized Official
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Title or Position | OWNER
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Name | KATHLEEN SPROLE
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Credential | MSW, LICSW
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Telephone | 612-915-0595
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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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