Healthcare Provider Details

I. General information

NPI: 1871408427
Provider Name (Legal Business Name): JOSELYN MASON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MILLER TRUNK HWY STE 500
DULUTH MN
55811-5644
US

IV. Provider business mailing address

1301 MILLER TRUNK HWY STE 500
DULUTH MN
55811-5644
US

V. Phone/Fax

Practice location:
  • Phone: 218-481-7390
  • Fax: 218-481-7263
Mailing address:
  • Phone: 218-481-7290
  • Fax: 218-481-7263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: