Catherine Brosious

Individual provider Active NPI Behavior Technician · White Bear Lake, MN

NPI 1669247656 · NPPES record last updated Nov 20, 2023

Key facts

NPI
1669247656
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
106S00000X (MN)
Practice address
1011 Meadowlands Dr Ste 1
White Bear Lake, MN 55127-2340
Phone
(651) 200-5417
NPI assigned
Nov 20, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
106S00000XMNMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 106S00000X MN Yes

Addresses

Primary practice location

1011 Meadowlands Dr Ste 1
White Bear Lake, MN 55127-2340

Mailing address

1041 County Road D E Apt 106
Saint Paul, MN 55109-5245
Phone (651) 200-5417

Other providers in White Bear Lake, MN

All providers in White Bear Lake, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.