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NPI Code Detail

MEDICARE: KIRSTIN K PALMQUIST MS, BCBA

MEDICARE: KIRSTIN K PALMQUIST MS, BCBA
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
1103K00000XBehavior Analyst1-21-53017MN

General Provider Information

NPI Number : 1720731771
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRSTIN K PALMQUIST MS, BCBA
Provider Business Mailing Address
First Line : 4595 NATHAN LN N APT 301
Second Line :
City : PLYMOUTH
State : MN
Zip : 55442-3190
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10180 VIKING DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7207
Country : US
Telephone Number : 612-509-6680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2022
Last Update Date : 06/05/2026

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