NPI 1609551472 · live from the CMS NPI Registry
Minuteclinic Diagnostic Of Minnesota, P.A.
Social Worker, Clinical in Eagan, MN. National Provider Identifier 1609551472, active.
NPI record
| NPI | 1609551472 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 4241 Johnny Cake Ridge Rd, Eagan, MN 55122 |
| Practice phone | 855-417-2486 |
| Mailing address | Po Box 772, Woonsocket, RI 02895 |
| Enumerated | June 20, 2023 |
| Last updated | June 20, 2023 |
| Authorized official | Deborah Pincince, Administrator |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional | 101YP2500X | — |
| Marriage & Family Therapist | 106H00000X | — |
| Social Worker, Clinical primary | 1041C0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.