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General NPI Number Information
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NPI Number | 1750927042
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Entity Type | Individual
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Provider Name | COLLIN WILLIAM STANHOPE
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Gender | Male
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 2872 26TH AVE S # DOORD
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-1529
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Country | US
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Telephone | 612-722-9013
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Fax |
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Provider Business Mailing Address
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Address Line | 2016 ALDRICH AVE S APT 4
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City | MINNEAPOLIS
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State | MN
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Zip | 55405-3057
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 27541
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License Number State | MN
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