Jaden Ellefson
Individual provider Active NPI Behavior Technician · Hermantown, MN
NPI 1184460792 · NPPES record last updated Jul 2, 2024
Key facts
- NPI
- 1184460792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 4140 Richard Ave Ste 200&300
Hermantown, MN 55811-2869 - Phone
- (218) 514-5230
- NPI assigned
- Jul 2, 2024
- 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
4140 Richard Ave Ste 200&300
Hermantown, MN 55811-2869
Mailing address
8366 Berg Lind Rd E
Saginaw, MN 55779-8068
Other providers in Hermantown, MN
- Brooke Marie Eddy
- Edgewood Hermantown 1 Senior Living LLC
- Edgewood Hermantown I Senior Living LLC
- Edgewood Hermantown II Senior Living LLC
- Mara Suzanne Edison
- Lucas Michael Elsner
- Cassie Endsley
- Dixie Engebretsen
- Christie Ehle Erickson IX
- Abileen Ann Erwin
All providers in Hermantown, 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 Jul 2, 2024. 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.