Basic Information
| Provider Information | |||||||||
| NPI: | 1558322263 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AIGNER | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MA, LP LIC SW LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 43 | ||||||||
| Address2: | MR 10809 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554400043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122624813 | ||||||||
| FaxNumber: | 6122624194 | ||||||||
| Practice Location | |||||||||
| Address1: | 407 W 66TH ST | ||||||||
| Address2: | |||||||||
| City: | RICHFIELD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554232374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6127988800 | ||||||||
| FaxNumber: | 6127988833 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 3005125 | WI | X | Behavioral Health & Social Service Providers | Psychologist | 103T00000X | LP3137 | MN | X | Behavioral Health & Social Service Providers | Psychologist | 104100000X | 12337 | MN | X | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.