Avila, Katheleen

Avila, Katheleen is an sole proprietor health care provider with primary practice located at 3608 44Th Ave S Kavila@Integrativemindfulness.Com, Minneapolis MN 55406-2906. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Avila, Katheleen can be contacted via phone (612) 872-9231.

Contact Information

Primary practice address
3608 44Th Ave S Kavila@Integrativemindfulness.Com Minneapolis MN 55406-2906
Phone: (612) 872-9231
Fax: (612) 722-3306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP0449 Minnesota

Profile Details

NPI number 1255305306
LBN Legal business name Avila, Katheleen
Credentials M.A. LIC PSYCHOLOGIS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 15th, 2006
Last updated Aug 5th, 2011 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255305306 NPPES
Minnesota MEDICAID 045248300

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