| Rochester Center For Autism, Inc | |
|
1220 4th Ave Sw Rochester MN 55902-3834 | |
| (507) 424-3234 | |
| (507) 424-3235 |
| Full Name | Rochester Center For Autism, Inc |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 1220 4th Ave Sw, Rochester, Minnesota |
| Authorized Official Name and Position | Mandy Marie Eggert (DIRECTOR/PROGRAM SUPERVISOR) |
| Authorized Official Contact | 5074243234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rochester Center For Autism, Inc 1220 4th Ave Sw Rochester MN 55902-3834 Ph: (507) 424-3234 | Rochester Center For Autism, Inc 1220 4th Ave Sw Rochester MN 55902-3834 Ph: (507) 424-3234 |
| NPI Number | 1730179995 |
|---|---|
| Provider Enumeration Date | 10/27/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730179995 | NPI | - | NPPES |
| 265K2RO | Other | MN | BCBS OF MN PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | LP0911 (Minnesota) | Primary |
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