Mensen, Nickole Mary

Mensen, Nickole Mary is an individual health care provider with primary practice located at 1011 Meadowlands Dr Ste 1And2 , White Bear Lake MN 55127-2339. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Mensen, Nickole Mary can be contacted via phone (612) 445-0301.

Contact Information

Primary practice address
1011 Meadowlands Dr Ste 1And2 White Bear Lake MN 55127-2339
Phone: (612) 445-0301
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X Minnesota

Profile Details

NPI number 1558936930
LBN Legal business name Mensen, Nickole Mary
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2021
Last updated May 26th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1558936930 NPPES
Minnesota MEDICAID 1588993091

Popular Providers