MEDICARE: MARY CATHERINE STENSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1205711793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CATHERINE STENSON

Provider Business Mailing Address
First Line	:	1804 CLOQUET AVE
Second Line	:
City	:	CLOQUET
State	:	MN
Zip	:	55720-2141
Country	:	US
Telephone Number	:	218-879-2119
Fax Number	:	218-879-2119

Provider Business Practice Location Address
First Line	:	3412 BENT TROUT LAKE RD
Second Line	:
City	:	BARNUM
State	:	MN
Zip	:	55707-8872
Country	:	US
Telephone Number	:	218-879-2119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2025
Last Update Date	:	08/06/2025

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Directions to “ MARY CATHERINE STENSON ” Practice Location

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