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NPI Code Detail

MEDICARE: SARAH KANE KNELLINGER

MEDICARE:   SARAH KANE KNELLINGER
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1225924392
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH KANE KNELLINGER
Provider Business Mailing Address
First Line : 1804 CLOQUET AVE
Second Line :
City : CLOQUET
State : MN
Zip : 55720-2141
Country : US
Telephone Number : 218-600-5303
Fax Number :
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 : 06/16/2025
Last Update Date : 06/16/2025

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Directions to “ SARAH KANE KNELLINGER ” Practice Location

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