Organization
MINNESOTA EARLY AUTISM PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LAUREE SCHUTT-CHARDON (DIRECTOR OF BILLING)
(608) 288-9040
Entity
Organization
Contact information
Practice address
7236 FORESTVIEW LN N, MAPLE GROVE, MN 55369-5656
(763) 493-7935
(763) 493-7936
Mailing address
6402 ODANA RD, ATTN: WEAP, MADISON, WI 53719-1123
(608) 288-9040
(608) 288-9042
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
MN
Other
Enumeration date
09/25/2007
Last updated
09/25/2007
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