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General NPI Number Information
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NPI Number | 1841945052
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Entity Type | Organization
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Legal Business Name | THE COLLEGE THERAPY CENTER
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 05/29/2023
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Provider Practice Location Address
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Address Line | 239 CLEVELAND AVE N
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City | SAINT PAUL
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State | MN
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Zip | 55104-5730
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Country | US
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Telephone | 612-712-6435
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Fax |
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Provider Business Mailing Address
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Address Line | 239 CLEVELAND AVE N
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City | SAINT PAUL
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State | MN
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Zip | 55104-5730
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Country | US
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Telephone | 612-712-6435
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK CHARLES CASTRENZE
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Credential |
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Telephone | 612-712-6435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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