Organization
AUTISM ASSISTANCE & THERAPY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN LAUBE (EXECUTIVE DIRECTOR)
(952) 448-6161
Entity
Organization
Contact information
Practice address
370 LIBERTY HEIGHTS DR, CHASKA, MN 55318-4607
(952) 448-6161
Mailing address
370 LIBERTY HEIGHTS DR, CHASKA, MN 55318-4607
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5121
MN
Other
Enumeration date
10/15/2011
Last updated
10/15/2011
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