Provider Demographics
NPI:1942667274
Name:TECHNICAL ACADEMIES OF MINNESOTA
Entity Type:Organization
Organization Name:TECHNICAL ACADEMIES OF MINNESOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNICK
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:320-262-5640
Mailing Address - Street 1:1705 16TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-2277
Mailing Address - Country:US
Mailing Address - Phone:320-262-5640
Mailing Address - Fax:320-262-5641
Practice Address - Street 1:1705 16TH ST NE
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-2277
Practice Address - Country:US
Practice Address - Phone:320-262-5640
Practice Address - Fax:320-262-5641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-17
Last Update Date:2016-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4217251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)