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General NPI Number Information
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NPI Number | 1801611645
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Entity Type | Organization
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Legal Business Name | CYNTHIA MARKISON LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 5275 EDINA INDUSTRIAL BLVD STE 108
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City | EDINA
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State | MN
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Zip | 55439-2916
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Country | US
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Telephone | 612-474-4574
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Fax |
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Provider Business Mailing Address
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Address Line | 5425 COLFAX AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55419-1743
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Country | US
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Telephone | 612-280-8085
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA MARKISON
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Credential | MSW, LICSW
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Telephone | 612-474-4574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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