Provider Demographics
NPI:1487547550
Name:INNOVATIVE MINDS ABA OF MINNESOTA, P.C.
Entity type:Organization
Organization Name:INNOVATIVE MINDS ABA OF MINNESOTA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & BCBA
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VUE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:559-790-8136
Mailing Address - Street 1:202 N CEDAR AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-2306
Mailing Address - Country:US
Mailing Address - Phone:559-790-8136
Mailing Address - Fax:844-946-0884
Practice Address - Street 1:202 N CEDAR AVE STE 1
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-2306
Practice Address - Country:US
Practice Address - Phone:559-790-8136
Practice Address - Fax:844-946-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty