Harley Jean Brake Walker
Individual provider Active NPI Behavior Technician · Shakopee, MN
NPI 1104430255 · NPPES record last updated Sep 5, 2020
Key facts
- NPI
- 1104430255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 4201 Dean Lakes Blvd
Shakopee, MN 55379-2829 - Phone
- (320) 241-2413
- NPI assigned
- Sep 5, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
4201 Dean Lakes Blvd
Shakopee, MN 55379-2829
Mailing address
4201 Dean Lakes Blvd
Shakopee, MN 55379-2829
Other providers in Shakopee, MN
- Cara Leanne Borggren
- Natalie Rose Borrell
- Kimberly C Bourassa
- Jennifer Elizabeth Boyd
- Marquitta Crystal Braih
- Jamie Brandell
- Hilary Breedon
- Teresa L Brenke
- Jonathan Pierce Brennan
- Bridge Chiropractic
All providers in Shakopee, MN · Behavior Technician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.