| Inner Outfitters, Inc | |
|
1409 Willow St Suite 200 Minneapolis MN 55403-2269 | |
| (612) 874-8608 | |
| (612) 874-8612 |
| Full Name | Inner Outfitters, Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1409 Willow St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Sandra Mary Kacher (PSYCHOTHERAPIST) |
| Authorized Official Contact | 6128748608 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Outfitters, Inc 1409 Willow St Suite 200 Minneapolis MN 55403-2269 Ph: (612) 874-8608 | Inner Outfitters, Inc 1409 Willow St Suite 200 Minneapolis MN 55403-2269 Ph: (612) 874-8608 |
| NPI Number | 1790097327 |
|---|---|
| Provider Enumeration Date | 07/12/2010 |
| Last Update Date | 07/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790097327 | NPI | - | NPPES |
| 1609932540 | Other | MN | NPI INDIVIDUAL NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 01976 (Minnesota) | Primary |
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