| Paul Mladnick Consulting Llc | |
|
1068 Lake St S Ste 109 Forest Lake MN 55025-2633 | |
| (651) 982-4792 | |
| (651) 982-6035 |
| Full Name | Paul Mladnick Consulting Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1068 Lake St S Ste 109, Forest Lake, Minnesota |
| Authorized Official Name and Position | Paul Mladnick (OWNER) |
| Authorized Official Contact | 6127197966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Mladnick Consulting Llc 1068 Lake St S Ste 109 Forest Lake MN 55025-2633 Ph: (651) 982-4792 | Paul Mladnick Consulting Llc 1068 Lake St S Ste 109 Forest Lake MN 55025-2633 Ph: (651) 982-4792 |
| NPI Number | 1467219089 |
|---|---|
| Provider Enumeration Date | 02/29/2024 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 8325580947 |
|---|---|
| Medicare Enrollment ID | O20240610003865 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467219089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Paul Luke Mladnick |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1487843355 PECOS PAC ID: 3577901321 Enrollment ID: I20240329001598 |
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