Minnesota Behavioral Specialists | |
4635 Nicols Rd # 104 Eagan MN 55122-3337 | |
(651) 900-2110 | |
Not Available |
Full Name | Minnesota Behavioral Specialists |
---|---|
Speciality | Behavior Analyst |
Location | 4635 Nicols Rd # 104, Eagan, Minnesota |
Authorized Official Name and Position | Paige Berland (CLINICAL SUPERVISOR) |
Authorized Official Contact | 6122896480 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Minnesota Behavioral Specialists 4635 Nicols Rd # 104 Eagan MN 55122-3337 Ph: (651) 900-2110 | Minnesota Behavioral Specialists 4635 Nicols Rd # 104 Eagan MN 55122-3337 Ph: (651) 900-2110 |
NPI Number | 1932734811 |
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Provider Enumeration Date | 03/11/2020 |
Last Update Date | 03/26/2020 |
Certification Date | 03/26/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932734811 | NPI | - | NPPES |
1891091864 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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