Organization
ROCHESTER CENTER FOR AUTISM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MANDY MARIE EGGERT (DIRECTOR/PROGRAM SUPERVISOR)
(507) 424-3234
Entity
Organization
Contact information
Practice address
1220 4TH AVE SW, ROCHESTER, MN 55902-3834
(507) 424-3234
(507) 424-3235
Mailing address
1220 4TH AVE SW, ROCHESTER, MN 55902-3834
(507) 424-3234
(507) 424-3235
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
LP0911
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265K2RO
BCBS OF MN PROVIDER #
MN
Enumeration date
10/27/2005
Last updated
08/22/2020
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