| Amth9085 | |
|
25 36th Avenue Cir S Moorhead MN 56560-5558 | |
| (701) 333-8675 | |
| Not Available |
| Full Name | Amth9085 |
|---|---|
| Speciality | Behavior Analyst |
| Location | 25 36th Avenue Cir S, Moorhead, Minnesota |
| Authorized Official Name and Position | Allison Moum-kasin (BEHAVIOR ANALYST) |
| Authorized Official Contact | 7013338675 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amth9085 25 36th Avenue Cir S Moorhead MN 56560-5558 Ph: (701) 333-8675 | Amth9085 25 36th Avenue Cir S Moorhead MN 56560-5558 Ph: (701) 333-8675 |
| NPI Number | 1942063417 |
|---|---|
| Provider Enumeration Date | 02/06/2024 |
| Last Update Date | 02/06/2024 |
| Certification Date | 02/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942063417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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