Provider Demographics
NPI:1033568514
Name:TUWEI, MAGGIE DORIS
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:DORIS
Last Name:TUWEI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 CASTLE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-1507
Mailing Address - Country:US
Mailing Address - Phone:507-351-8560
Mailing Address - Fax:
Practice Address - Street 1:1639 CASTLE DR
Practice Address - Street 2:
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003-1507
Practice Address - Country:US
Practice Address - Phone:507-351-8560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN107773-1-HCBS320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities