| Midwest Center For Emdr Training | |
|
6400 Flying Cloud Dr Ste 180 Eden Prairie MN 55344-3337 | |
| (612) 812-7857 | |
| (952) 600-4136 |
| Full Name | Midwest Center For Emdr Training |
|---|---|
| Speciality | Psychologist |
| Location | 6400 Flying Cloud Dr, Eden Prairie, Minnesota |
| Authorized Official Name and Position | Patti J Miller (DIRECTOR) |
| Authorized Official Contact | 6128127857 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Center For Emdr Training 6400 Flying Cloud Dr Ste 180 Eden Prairie MN 55344-3337 Ph: (612) 812-7857 | Midwest Center For Emdr Training 6400 Flying Cloud Dr Ste 180 Eden Prairie MN 55344-3337 Ph: (612) 812-7857 |
| NPI Number | 1316716731 |
|---|---|
| Provider Enumeration Date | 12/27/2023 |
| Last Update Date | 12/27/2023 |
| Certification Date | 12/27/2023 |
| Medicare PECOS PAC ID | 1052856499 |
|---|---|
| Medicare Enrollment ID | O20240710002698 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316716731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Patti Jane Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073734430 PECOS PAC ID: 2961947304 Enrollment ID: I20240710002794 |
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