Boutwell, Madison Diane
Boutwell, Madison Diane is an individual health care provider with primary practice located at 8980 Zachary Ln N , Maple Grove MN 55369-4018. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Boutwell, Madison Diane can be contacted via phone (612) 767-7222.Contact Information
Primary practice address
8980 Zachary Ln N
Maple Grove MN 55369-4018
Phone: (612) 767-7222
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X |
Profile Details
| NPI number | 1053987958 |
|---|---|
| LBN Legal business name | Boutwell, Madison Diane |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2021 |
| Last updated | Jun 1st, 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.
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