| Midwest Autism & Psychological Services, Pllc | |
|
12400 Portland Ave, Ste 130 Burnsville MN 55337-4915 | |
| (763) 607-7817 | |
| Not Available |
| Full Name | Midwest Autism & Psychological Services, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 12400 Portland Ave, Ste 130, Burnsville, Minnesota |
| Authorized Official Name and Position | Megan Manty (OWNER) |
| Authorized Official Contact | 7636077817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Autism & Psychological Services, Pllc 227 Tower Ave Dundas MN 55019-3989 Ph: (763) 607-7817 | Midwest Autism & Psychological Services, Pllc 12400 Portland Ave, Ste 130 Burnsville MN 55337-4915 Ph: (763) 607-7817 |
| NPI Number | 1407561582 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 06/26/2023 |
| Certification Date | 06/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407561582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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