MEDICARE: MS. MARILYN ANNE GANJE-FLING M.A.,L.P.

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	103T00000X	Psychologist	1330	MN
2	103TC1900X	Counseling Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	522K7GA	OTHER	MN	BLUE CROSS BLUE SHIELD
2	62-54592	OTHER		MEDICA

General Provider Information

NPI Number	:	1578661534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARILYN ANNE GANJE-FLING M.A.,L.P.

Provider Business Mailing Address
First Line	:	4839 COLFAX AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55419-5319
Country	:	US
Telephone Number	:	952-929-1905
Fax Number	:	952-929-1771

Provider Business Practice Location Address
First Line	:	4500 PARK GLEN RD
Second Line	:	SUITE 350
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-4871
Country	:	US
Telephone Number	:	952-929-1905
Fax Number	:	952-929-1771

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/11/2025

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