Autism Family Therapy Inc | |
12805 Highway 55 Suite 402 Plymouth MN 55441-3859 | |
(612) 597-0459 | |
Not Available |
Full Name | Autism Family Therapy Inc |
---|---|
Speciality | Marriage & Family Therapist |
Location | 12805 Highway 55, Plymouth, Minnesota |
Authorized Official Name and Position | Tamara Faye Phillips (PRESIDENT) |
Authorized Official Contact | 6125970459 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Autism Family Therapy Inc 6080 Ives Ln N Plymouth MN 55442-1241 Ph: (612) 597-0459 | Autism Family Therapy Inc 12805 Highway 55 Suite 402 Plymouth MN 55441-3859 Ph: (612) 597-0459 |
NPI Number | 1194101212 |
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Provider Enumeration Date | 07/31/2015 |
Last Update Date | 07/31/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194101212 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | 2491 (Minnesota) | Primary |
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