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NPI Code Detail

MEDICARE: KIMBERLY ASPEN

MEDICARE: KIMBERLY ASPEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1043892623
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ASPEN
Provider Business Mailing Address
First Line : 5868 BAKER RD
Second Line :
City : MINNETONKA
State : MN
Zip : 55345-5903
Country : US
Telephone Number : 952-767-4200
Fax Number :
Provider Business Practice Location Address
First Line : 10180 VIKING DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7207
Country : US
Telephone Number : 952-767-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2021
Last Update Date : 04/23/2021

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Directions to “ KIMBERLY ASPEN ” Practice Location

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