| Dynamic Connections, Inc. | |
|
2495 Maplewood Dr Ste 312 Maplewood MN 55109-1985 | |
| (651) 760-3109 | |
| (651) 967-9417 |
| Full Name | Dynamic Connections, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 2495 Maplewood Dr Ste 312, Maplewood, Minnesota |
| Authorized Official Name and Position | Kristi Kay Worrell (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6517603109 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Connections, Inc. 2495 Maplewood Dr Ste 312 Maplewood MN 55109-1985 Ph: (651) 760-3109 | Dynamic Connections, Inc. 2495 Maplewood Dr Ste 312 Maplewood MN 55109-1985 Ph: (651) 760-3109 |
| NPI Number | 1265791503 |
|---|---|
| Provider Enumeration Date | 05/07/2012 |
| Last Update Date | 08/24/2020 |
| Certification Date | 08/20/2020 |
| Medicare PECOS PAC ID | 6507183456 |
|---|---|
| Medicare Enrollment ID | O20150402001417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265791503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Primary |
| 261QR0400X | Clinic/center - Rehabilitation | (* (Not Available)) | Secondary |
| Provider Name | Kara A Schultz |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568506897 PECOS PAC ID: 7012807217 Enrollment ID: I20040319000788 |
| Provider Name | Kristi K Worrell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942344544 PECOS PAC ID: 9133179773 Enrollment ID: I20050131001046 |
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