| Karen Stoddard Llc | |
|
1219 University Ave Se Minneapolis MN 55414-2038 | |
| (651) 271-1905 | |
| Not Available |
| Full Name | Karen Stoddard Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1219 University Ave Se, Minneapolis, Minnesota |
| Authorized Official Name and Position | Karen Elizabeth Stoddard (OWNER) |
| Authorized Official Contact | 6512711905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Karen Stoddard Llc 2146 Berkeley Ave Saint Paul MN 55105-1204 Ph: (651) 271-1905 | Karen Stoddard Llc 1219 University Ave Se Minneapolis MN 55414-2038 Ph: (651) 271-1905 |
| NPI Number | 1750938494 |
|---|---|
| Provider Enumeration Date | 08/19/2019 |
| Last Update Date | 08/19/2019 |
| Medicare PECOS PAC ID | 3072842012 |
|---|---|
| Medicare Enrollment ID | O20190917000989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750938494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Karen E Stoddard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528330453 PECOS PAC ID: 0446418693 Enrollment ID: I20120220001068 |
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