| St. Cloud State University | |
|
151 8th St S Rm 115 Saint Cloud MN 56301-4423 | |
| (320) 308-4238 | |
| Not Available |
| Full Name | St. Cloud State University |
|---|---|
| Speciality | Behavior Analyst |
| Location | 151 8th St S Rm 115, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Shonda Craft (DEAN, COLLEGE OF HEALTH & WELLNESS) |
| Authorized Official Contact | 3203084732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Cloud State University 720 4th Ave S Saint Cloud MN 56301-4442 Ph: () - | St. Cloud State University 151 8th St S Rm 115 Saint Cloud MN 56301-4423 Ph: (320) 308-4238 |
| NPI Number | 1902590805 |
|---|---|
| Provider Enumeration Date | 06/05/2023 |
| Last Update Date | 06/05/2023 |
| Certification Date | 06/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902590805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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