| Amazing You Therapy | |
|
421 1st Ave Sw Ste 300w Rochester MN 55902-3389 | |
| (507) 722-1139 | |
| Not Available |
| Full Name | Amazing You Therapy |
|---|---|
| Speciality | Clinic/Center |
| Location | 421 1st Ave Sw Ste 300w, Rochester, Minnesota |
| Authorized Official Name and Position | Casey Marie Larson (OWNER) |
| Authorized Official Contact | 5077221139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amazing You Therapy 421 1st Ave Sw Ste 300w Rochester MN 55902-3389 Ph: (507) 722-1139 | Amazing You Therapy 421 1st Ave Sw Ste 300w Rochester MN 55902-3389 Ph: (507) 722-1139 |
| NPI Number | 1780207829 |
|---|---|
| Provider Enumeration Date | 05/23/2020 |
| Last Update Date | 08/03/2020 |
| Certification Date | 08/03/2020 |
| Medicare PECOS PAC ID | 6800219437 |
|---|---|
| Medicare Enrollment ID | O20200714003883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780207829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Casey Marie Larson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053934190 PECOS PAC ID: 7618390246 Enrollment ID: I20200714003899 |
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