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Search › Minnesota › 235Z00000X

Autumn Kallock

NPI 1538905427 · on the registry since 2024

Practice

Address
1420 4th Ave Nw
East Grand Forks, MN 56721
Phone
(218) 773-3494
Organisation at this address
Polk Co Ind School Dist 595
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Additional practice sites

  • 2200 Library Cir, Grand Forks, ND
  • 2951 S 34th St, Grand Forks, ND

Registry record

Primary taxonomy
235Z00000X
235Z00000X
Licence states on file
ND
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-04-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota