Provider Demographics
NPI:1134457047
Name:BEHAVIOR THERAPY SOLUTIONS OF MINNESOTA
Entity Type:Organization
Organization Name:BEHAVIOR THERAPY SOLUTIONS OF MINNESOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:651-249-8489
Mailing Address - Street 1:700 COMMERCE DR STE 260
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-9243
Mailing Address - Country:US
Mailing Address - Phone:651-328-6280
Mailing Address - Fax:
Practice Address - Street 1:700 COMMERCE DR STE 260
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-9243
Practice Address - Country:US
Practice Address - Phone:651-328-6280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-04
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4657103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty