Provider Demographics
NPI:1518540251
Name:MESSER, MADISON
Entity type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:
Last Name:MESSER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:SCHWANDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:690 CLEVELAND AVE S STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1319
Mailing Address - Country:US
Mailing Address - Phone:651-493-8412
Mailing Address - Fax:651-927-0404
Practice Address - Street 1:690 CLEVELAND AVE S STE 100
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1319
Practice Address - Country:US
Practice Address - Phone:651-493-8412
Practice Address - Fax:651-927-0404
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician