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Organization

LITTLE BIRD PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEONNE M. PANSCH LICSW (PSYCHOTHERAPIST)
(218) 760-9357
Entity
Organization

Contact information

Practice address
48858 US 71, LAPORTE, MN 56461-4879
(218) 760-9357
Mailing address
48858 US 71, LAPORTE, MN 56461

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
19439
MN
261QM0850X
Adult Mental Health Clinic/Center
19439
MN
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
19439
MN

Other

Enumeration date
08/14/2012
Last updated
08/14/2012
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