Provider Demographics
NPI:1023671468
Name:CHAMPINE, MARGARET NIMOCKS (MA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:NIMOCKS
Last Name:CHAMPINE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:NIMOCKS
Other - Last Name:CHAMPINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2200 COLFAX AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-2866
Mailing Address - Country:US
Mailing Address - Phone:507-230-3030
Mailing Address - Fax:
Practice Address - Street 1:310 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3218
Practice Address - Country:US
Practice Address - Phone:507-230-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional