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NPI Code Detail

MEDICARE: CYNTHIA JANE MARKISON LICSW

MEDICARE: CYNTHIA JANE MARKISON LICSW
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
1104100000XSocial Worker16388MN

General Provider Information

NPI Number : 1881737187
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA JANE MARKISON LICSW
Provider Business Mailing Address
First Line : 1100 GLENWOOD AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55405-1430
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1100 GLENWOOD AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55405-1430
Country : US
Telephone Number : 952-975-7463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 01/07/2015

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Directions to “ CYNTHIA JANE MARKISON LICSW” Practice Location

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