Organization
MYNA EARLY INTERVENTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE K. DOERFLER (AUTHORIZING OFFICIAL)
(701) 347-1782
Entity
Organization
Contact information
Practice address
4575 23RD AVE S STE 400, FARGO, ND 58104-8783
(701) 347-1782
(701) 404-8274
Mailing address
4575 23RD AVE S STE 400, FARGO, ND 58104-8783
(701) 347-1782
(701) 404-8274
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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