Trista Marie Carlson

NPI #1003589813 in Virginia, Minnesota

Provider Information

NPI Number: 1003589813
Entity Type: Individual
Name: Trista Marie Carlson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jul 28, 2021
Last Updated: Jul 28, 2021

Practice Location

Address: 910 8TH ST S STE B
City: Virginia
State: Minnesota
ZIP Code: 55792-3236
Phone: (218) 748-8500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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