Provider Demographics
NPI:1679649602
Name:GRASKE, THOMAS MICHAEL (MA LP CSAT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:GRASKE
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Gender:M
Credentials:MA LP CSAT
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Mailing Address - Street 1:521 TANGLEWOOD DRIVE
Mailing Address - Street 2:THOMAS M GRASKE MA LP CSAT WOODCREST COUNSELING INC
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-2016
Mailing Address - Country:US
Mailing Address - Phone:763-753-1785
Mailing Address - Fax:763-753-1753
Practice Address - Street 1:521 TANGLEWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-2016
Practice Address - Country:US
Practice Address - Phone:763-753-1785
Practice Address - Fax:763-753-1753
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MNLP3334103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist