| Neurodiver-city Llc | |
|
406 2nd Ave E Shakopee MN 55379-1510 | |
| (651) 249-6739 | |
| Not Available |
| Full Name | Neurodiver-city Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 406 2nd Ave E, Shakopee, Minnesota |
| Authorized Official Name and Position | Christy Carpenter (OPERATIONS OFFICER) |
| Authorized Official Contact | 6512496739 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurodiver-city Llc 406 2nd Ave E Shakopee MN 55379-1510 Ph: (651) 249-6739 | Neurodiver-city Llc 406 2nd Ave E Shakopee MN 55379-1510 Ph: (651) 249-6739 |
| NPI Number | 1073319737 |
|---|---|
| Provider Enumeration Date | 02/24/2025 |
| Last Update Date | 02/24/2025 |
| Certification Date | 02/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073319737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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