Carissa Brossard
Individual provider Active NPI Behavior Technician · Red Wing, MN
NPI 1245097583 · NPPES record last updated Mar 4, 2024
Key facts
- NPI
- 1245097583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 4911 Learning LN
Red Wing, MN 55066-4533 - Phone
- (651) 360-3202
- NPI assigned
- Mar 4, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River City Therapy Center, LLC | Behavior Technician | Current |
Accepting new patients |
Locations
4911 Learning Ln
Red Wing, MN 55066
Phone (651) 360-3202
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
4911 Learning LN
Red Wing, MN 55066-4533
Mailing address
1515 Phelps St
Red Wing, MN 55066-3546
Other providers in Red Wing, MN
- Karla K Breuer
- Brian Bergan Dentistry, Inc.
- Amanda Bridges
- Matthew James Britton
- Tova Jean Brookshaw
- Christopher Scot Brown
- Susan Lyn Brown
- Sarah June Brumbaugh
- Donald L Bruns
- Michaela Nicole Bryan
All providers in Red Wing, MN · Behavior Technician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.