Medo, Susan A

Medo, Susan A is an sole proprietor health care provider with primary practice located at 100 W Franklin Ave , Minneapolis MN 55404-2433. She recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as her primary health care specialty. Medo, Susan A can be contacted via phone (612) 203-8088.

Contact Information

Primary practice address
100 W Franklin Ave Minneapolis MN 55404-2433
Phone: (612) 203-8088
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X LP3998 Minnesota

Profile Details

NPI number 1174686216
LBN Legal business name Medo, Susan A
Credentials MA LP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 19th, 2006
Last updated Oct 17th, 2008 - about 17 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 1174686216 NPPES
Minnesota Other 210D4ME BCBS
Minnesota MEDICAID 756187300 BCBS

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