Ellie Anderson

Individual provider Active NPI Behavior Technician · Bloomington, MN

NPI 1124962873 · NPPES record last updated Apr 15, 2026

Key facts

NPI
1124962873
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1401 American Blvd E Ste 8
Bloomington, MN 55425-4507
Phone
(763) 283-8815
NPI assigned
Apr 15, 2026
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)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1401 American Blvd E Ste 8
Bloomington, MN 55425-4507

Mailing address

1401 American Blvd E Ste 8
Bloomington, MN 55425-4507
Phone (763) 283-8815

Other providers in Bloomington, MN

All providers in Bloomington, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.