Provider Demographics
NPI:1629894647
Name:EMPOWER THERAPY LLC
Entity type:Organization
Organization Name:EMPOWER THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KOWSARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:612-799-9656
Mailing Address - Street 1:5275 EDINA INDUSTRIAL BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2916
Mailing Address - Country:US
Mailing Address - Phone:612-799-9656
Mailing Address - Fax:
Practice Address - Street 1:5275 EDINA INDUSTRIAL BLVD STE 209
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2916
Practice Address - Country:US
Practice Address - Phone:612-799-9656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)