Michael Menzie
Behavior Technician in Baxter, MN. Individual provider (NPI-1).
NPI number1841024486
StatusActive
Last updated in NPPESAug 27, 2024
Details
- NPI
- 1841024486
- Entity type
- Individual (NPI-1)
- Name
- Michael Menzie
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 27, 2024
- Certification date
- Aug 27, 2024
- Last updated
- Aug 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
7938 College RdBaxter, MN 56425-8636
Phone 218-270-2918
Mailing address
7938 College RdBaxter, MN 56425-8636
Phone 218-270-2918
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