| Redefyne | |
|
17025 Commercial Park Road Suite 7 Brainerd MN 56401 | |
| (218) 232-6971 | |
| Not Available |
| Full Name | Redefyne |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 17025 Commercial Park Road, Brainerd, Minnesota |
| Authorized Official Name and Position | Ashley A Roberts (OWNER) |
| Authorized Official Contact | 2182326971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Redefyne 17025 Commercial Park Road Suite 7 Brainerd MN 56401 Ph: (218) 232-6971 | Redefyne 17025 Commercial Park Road Suite 7 Brainerd MN 56401 Ph: (218) 232-6971 |
| NPI Number | 1447996178 |
|---|---|
| Provider Enumeration Date | 05/06/2022 |
| Last Update Date | 12/01/2022 |
| Certification Date | 12/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447996178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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