Provider Demographics
NPI:1396403143
Name:MINKLER, SAIGE GENEVIEVE
Entity Type:Individual
Prefix:
First Name:SAIGE
Middle Name:GENEVIEVE
Last Name:MINKLER
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 1:2912 42ND AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1820
Mailing Address - Country:US
Mailing Address - Phone:907-306-4638
Mailing Address - Fax:
Practice Address - Street 1:2912 42ND AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1820
Practice Address - Country:US
Practice Address - Phone:907-306-4638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician