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NPI Code Detail

MEDICARE: KARI ANN TRASK AD

MEDICARE: KARI ANN TRASK AD
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1306433891
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARI ANN TRASK AD
Provider Business Mailing Address
First Line : 910 8TH ST S STE B
Second Line :
City : VIRGINIA
State : MN
Zip : 55792-3236
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 910 8TH ST S STE B
Second Line :
City : VIRGINIA
State : MN
Zip : 55792-3236
Country : US
Telephone Number : 218-748-8500
Fax Number : 218-748-8501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2020
Last Update Date : 12/30/2020

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Directions to “ KARI ANN TRASK AD” Practice Location

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