| John Defrancisco, Llc | |
|
303 1st Ave Ne Ste 220 Faribault MN 55021-5244 | |
| (507) 332-8082 | |
| Not Available |
| Full Name | John Defrancisco, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 303 1st Ave Ne Ste 220, Faribault, Minnesota |
| Authorized Official Name and Position | John Defrancisco (DIRECTOR / PSYCHOLOGIST) |
| Authorized Official Contact | 9522405330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Defrancisco, Llc 303 1st Ave Ne Ste 220 Faribault MN 55021-5244 Ph: (507) 332-8082 | John Defrancisco, Llc 303 1st Ave Ne Ste 220 Faribault MN 55021-5244 Ph: (507) 332-8082 |
| NPI Number | 1972020154 |
|---|---|
| Provider Enumeration Date | 08/28/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972020154 | NPI | - | NPPES |
| 1477537355 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP0411 (Minnesota) | Primary |
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