Michell Dahl

Individual provider Active NPI Behavior Technician · Fargo, ND

NPI 1124695705 · NPPES record last updated Jun 10, 2021

Key facts

NPI
1124695705
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
3401 45TH St S
Fargo, ND 58104-8970
Phone
(701) 356-4384
Fax
(701) 356-4383
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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
Pediatric Therapy Partners, Inc. Current
since Jun 15, 2021
Accepting new patients
Pediatric Therapy Partners, Inc. Behavior Technician Current
since Jun 15, 2021
Accepting new patients

Locations

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

3401 45th St S
Fargo, ND 58104
Phone (701) 356-4384

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

3401 45TH St S
Fargo, ND 58104-8970

Mailing address

3060 Frontier Way S
Fargo, ND 58104-8909
Phone (701) 232-2340

Other providers in Fargo, ND

All providers in Fargo, ND · Behavior Technician in North Dakota

Sources for this page

Verify at the official NPI Registry.