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1131 N 11th Ave E Duluth MN 55805-1517 | |
| (218) 724-7953 | |
| (218) 628-1347 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1131 N 11th Ave E, Duluth, Minnesota |
| Authorized Official Name and Position | Melissa Winkler (DIRECTOR OF QUALITY ASSURANCE) |
| Authorized Official Contact | 2186252638 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1131 N 11th Ave E Duluth MN 55805-1517 Ph: (218) 724-7953 | 1131 N 11th Ave E Duluth MN 55805-1517 Ph: (218) 724-7953 |
| NPI Number | 1508922386 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 05/12/2021 |
| Certification Date | 05/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508922386 | NPI | - | NPPES |
| 8457171 | Other | MEDICA | |
| 5A44NO | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
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