Individual provider · NPI-1

Marlvetta Alicia Mason

Case Management · Maple Grove, MN

NPI number1457246142
StatusActive
Last updated in NPPESJun 11, 2025

Details

NPI
1457246142
Entity type
Individual (NPI-1)
Name
Marlvetta Alicia Mason
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 11, 2025
Certification date
Jun 9, 2025
Last updated
Jun 11, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251B00000X Case Management––Yes

Practice location

8094 Evergreen Ln N
Maple Grove, MN 55369-3266

Phone 612-423-6511

Mailing address

8094 Evergreen Ln N
Maple Grove, MN 55369-3266

Phone 612-423-6511

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