Provider Demographics
NPI:1578375382
Name:MCLINN, MARIA THERESA SPARTZ
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:THERESA SPARTZ
Last Name:MCLINN
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 1:1240 THIRD AVENUE EAST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379
Mailing Address - Country:US
Mailing Address - Phone:952-777-4996
Mailing Address - Fax:952-444-2875
Practice Address - Street 1:1240 3RD AVE E STE 100
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-1679
Practice Address - Country:US
Practice Address - Phone:952-777-4996
Practice Address - Fax:952-444-2875
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician