| |
209 Snelling Ave N Saint Paul MN 55104-6326 | |
(507) 850-0377 | |
Not Available |
Full Name | |
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Speciality | Social Worker |
Location | 209 Snelling Ave N, Saint Paul, Minnesota |
Authorized Official Name and Position | Caitlin Tharaldson (OWNER/THERAPIST) |
Authorized Official Contact | 6514421685 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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209 Snelling Ave N Saint Paul MN 55104-6326 Ph: () - | 209 Snelling Ave N Saint Paul MN 55104-6326 Ph: (507) 850-0377 |
NPI Number | 1477307890 |
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Provider Enumeration Date | 04/12/2024 |
Last Update Date | 12/16/2024 |
Certification Date | 12/16/2024 |
Medicare PECOS PAC ID | 7618418260 |
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Medicare Enrollment ID | O20240923001830 |
Identifier | Type | State | Issuer |
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1477307890 | NPI | - | NPPES |
Provider Name | Megan Rowe |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1275034605 PECOS PAC ID: 4385906585 Enrollment ID: I20231018003254 |
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