| Your Vision Achieved, Llc | |
|
1705 Southcross Dr W Unit 101 Burnsville MN 55306-7027 | |
| (952) 225-1575 | |
| Not Available |
| Full Name | Your Vision Achieved, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1705 Southcross Dr W Unit 101, Burnsville, Minnesota |
| Authorized Official Name and Position | Olga Lidia Tapia-farrell (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6122695313 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Vision Achieved, Llc Po Box 363 Farmington MN 55024-0363 Ph: (612) 269-5313 | Your Vision Achieved, Llc 1705 Southcross Dr W Unit 101 Burnsville MN 55306-7027 Ph: (952) 225-1575 |
| NPI Number | 1356752463 |
|---|---|
| Provider Enumeration Date | 05/12/2014 |
| Last Update Date | 04/15/2024 |
| Certification Date | 04/15/2024 |
| Medicare PECOS PAC ID | 0143763870 |
|---|---|
| Medicare Enrollment ID | O20240621002242 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356752463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1024 (Minnesota) | Primary |
| Provider Name | Olga Lidia Tapia-farrell |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1538426994 PECOS PAC ID: 1052854783 Enrollment ID: I20240621002421 |
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