| Carolyn Disch Llc | |
|
8120 Penn Ave S Ste 500f Bloomington MN 55431-1367 | |
| (612) 325-6904 | |
| Not Available |
| Full Name | Carolyn Disch Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8120 Penn Ave S Ste 500f, Bloomington, Minnesota |
| Authorized Official Name and Position | Carolyn E Disch (THERAPIST) |
| Authorized Official Contact | 6123256904 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolyn Disch Llc 8120 Penn Ave S Ste 500f Bloomington MN 55431-1367 Ph: (612) 325-6904 | Carolyn Disch Llc 8120 Penn Ave S Ste 500f Bloomington MN 55431-1367 Ph: (612) 325-6904 |
| NPI Number | 1366149775 |
|---|---|
| Provider Enumeration Date | 02/15/2023 |
| Last Update Date | 02/15/2023 |
| Certification Date | 02/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366149775 | NPI | - | NPPES |
| 1649910985 | Other | MN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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