| Autism Family Therapy Inc | |
|
12805 Highway 55 Suite 402 Plymouth MN 55441-3859 | |
| (612) 597-0459 | |
| Not Available |
| Full Name | Autism Family Therapy Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 12805 Highway 55, Plymouth, Minnesota |
| Authorized Official Name and Position | Tamara Faye Phillips (PRESIDENT) |
| Authorized Official Contact | 6125970459 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Family Therapy Inc 6080 Ives Ln N Plymouth MN 55442-1241 Ph: (612) 597-0459 | Autism Family Therapy Inc 12805 Highway 55 Suite 402 Plymouth MN 55441-3859 Ph: (612) 597-0459 |
| NPI Number | 1194101212 |
|---|---|
| Provider Enumeration Date | 07/31/2015 |
| Last Update Date | 07/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194101212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 2491 (Minnesota) | Primary |
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