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Organization
SKILLS - AUTISM THERAPY & PARENT ENRICHMENT
Active
Organization
SKILLS - AUTISM THERAPY & PARENT ENRICHMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FONDUNGALLAH ESQ (SECRETARY)
(651) 482-0520
Entity
Organization
Contact information
Practice address
2499 RICE ST STE 145, SAINT PAUL, MN 55113-3700
(651) 482-0520
Mailing address
2499 RICE ST STE 145, SAINT PAUL, MN 55113-3700
(651) 482-0520
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
NULL
Other
Enumeration date
05/20/2015
Last updated
06/12/2015
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