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Organization

PAVLIK MENTAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EMILY PAVLIK (OWNER, MENTAL HEALTH THERAPIST)
(651) 246-8895
Entity
Organization

Contact information

Practice address
15025 GLAZIER AVE STE 236B, APPLE VALLEY, MN 55124-6300
(651) 246-8895
Mailing address
15025 GLAZIER AVE STE 236B, APPLE VALLEY, MN 55124-6300
(651) 246-8895

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
2221
MN
251S00000X
Community/Behavioral Health Agency
Primary
301842
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2458577
MINNESOTA CARE TAX ID
MN
Enumeration date
05/09/2012
Last updated
05/09/2012
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