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General NPI Number Information
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NPI Number | 1912680133
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Entity Type | Individual
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Provider Name | CARSON RICE HINRICHS ALDRICH
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Gender | Male
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 731 BIELENBERG DR STE 102-104
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City | WOODBURY
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State | MN
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Zip | 55125-1700
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Country | US
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Telephone | 612-445-8326
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Fax |
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Provider Business Mailing Address
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Address Line | 12570 PORTLAND AVE APT 210
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City | BURNSVILLE
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State | MN
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Zip | 55337-7519
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Country | US
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Telephone | 630-532-9817
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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 |
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