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NPI Code Detail

MEDICARE: ANA GARCIA PONCE

MEDICARE: ANA GARCIA PONCE
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 : 1427821438
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANA GARCIA PONCE
Provider Business Mailing Address
First Line : 201 W BURNSVILLE PKWY STE 130H
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-2527
Country : US
Telephone Number : 952-600-2855
Fax Number : 612-234-6566
Provider Business Practice Location Address
First Line : 14041 BURNHAVEN DR STE 150
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-4442
Country : US
Telephone Number : 952-600-2855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2023
Last Update Date : 01/05/2024

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Directions to “ ANA GARCIA PONCE ” Practice Location

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