Organization
AUTISM SOCIETY OF MINNESOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN BRASCH (DIRECTOR)
(651) 647-1083
Entity
Organization
Contact information
Practice address
2380 WYCLIFF ST, SUITE 102, SAINT PAUL, MN 55114-1279
(651) 647-1083
Mailing address
2380 WYCLIFF ST, SUITE 102, SAINT PAUL, MN 55114-1279
(651) 647-1083
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
323J8AU
BLUE CROSS BLUE SHIELD
MN
Enumeration date
12/20/2005
Last updated
07/21/2022
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