| Maidman-joshua Inc | |
|
5200 Willson Rd Ste 150 Edina MN 55424-1300 | |
| (952) 926-4554 | |
| (952) 836-2730 |
| Full Name | Maidman-joshua Inc |
|---|---|
| Speciality | Psychologist |
| Location | 5200 Willson Rd Ste 150, Edina, Minnesota |
| Authorized Official Name and Position | Janice Madiman (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 9529264554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maidman-joshua Inc 5200 Willson Rd Ste 150 Edina MN 55424-1300 Ph: (952) 926-4554 | Maidman-joshua Inc 5200 Willson Rd Ste 150 Edina MN 55424-1300 Ph: (952) 926-4554 |
| NPI Number | 1710257175 |
|---|---|
| Provider Enumeration Date | 01/03/2012 |
| Last Update Date | 01/03/2012 |
| Medicare PECOS PAC ID | 6800057712 |
|---|---|
| Medicare Enrollment ID | O20120419000282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710257175 | NPI | - | NPPES |
| 1235276791 | Other | MN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP1361 (Minnesota) | Primary |
| Provider Name | Janice C Joshua |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235276791 PECOS PAC ID: 6305007253 Enrollment ID: I20120419000738 |
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