| Splady Therapy Services, Llc | |
|
205 W 2nd St Ste 421 Duluth MN 55802-1920 | |
| (218) 302-5440 | |
| (218) 302-5442 |
| Full Name | Splady Therapy Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 205 W 2nd St Ste 421, Duluth, Minnesota |
| Authorized Official Name and Position | Anna Splady (PSYCHOTHERAPIST) |
| Authorized Official Contact | 2183025440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Splady Therapy Services, Llc 205 W 2nd St Ste 421 Duluth MN 55802-1920 Ph: (218) 302-5440 | Splady Therapy Services, Llc 205 W 2nd St Ste 421 Duluth MN 55802-1920 Ph: (218) 302-5440 |
| NPI Number | 1992225668 |
|---|---|
| Provider Enumeration Date | 06/23/2017 |
| Last Update Date | 10/26/2020 |
| Certification Date | 10/26/2020 |
| Medicare PECOS PAC ID | 5092073726 |
|---|---|
| Medicare Enrollment ID | O20171229000187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992225668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 19887 (Minnesota) | Primary |
| Provider Name | Anna L Splady |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609109255 PECOS PAC ID: 7911173224 Enrollment ID: I20120106000660 |
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