Dariyan Rose Adams

Individual provider Active NPI Behavior Technician · Mankato, MN

NPI 1114569944 · NPPES record last updated Oct 14, 2019

Key facts

NPI
1114569944
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
220 E Main St Ste 1
Mankato, MN 56001-3574
Phone
(507) 345-7012
NPI assigned
Oct 14, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Mental Health LLC Current
since Nov 17, 2019
Accepting new patients

Locations

220 E Main St
Ste 1
Mankato, MN 56001
Phone (507) 345-7012

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

220 E Main St Ste 1
Mankato, MN 56001-3574

Mailing address

114 Cottage Path
Mankato, MN 56001-6131
Phone (651) 233-9068

Other providers in Mankato, MN

All providers in Mankato, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.