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General NPI Number Information
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NPI Number | 1588574529
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Entity Type | Individual
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Provider Name | MORGAN RIIS MITTELSTAEDT
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Gender | Female
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 1530 1ST AVE N STE 150
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City | MOORHEAD
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State | MN
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Zip | 56560-0002
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Country | US
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Telephone | 218-228-3296
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Fax |
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Provider Business Mailing Address
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Address Line | 20496 GADWALL LN
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City | ROGERS
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State | MN
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Zip | 55374-8767
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Country | US
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Telephone | 763-913-5934
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | MN
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