Healthcare Provider Details

I. General information

NPI: 1750851663
Provider Name (Legal Business Name): ANNAMARIE SAVARIEGO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 PARKWAY CIR STE 300
BROOKLYN CENTER MN
55430-2849
US

IV. Provider business mailing address

1540 E SAINT GERMAIN ST APT 124
SAINT CLOUD MN
56304-0627
US

V. Phone/Fax

Practice location:
  • Phone: 818-345-2345
  • Fax: --
Mailing address:
  • Phone: 786-913-3327
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: