Iman Abdalla
Individual provider Active NPI Behavior Technician · Shakopee, MN
NPI 1225751837 · NPPES record last updated Sep 20, 2022
Key facts
- NPI
- 1225751837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 4201 Dean Lakes Blvd Ste 160
Shakopee, MN 55379-2863 - Phone
- (612) 509-6681
- NPI assigned
- Sep 20, 2022
- 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 Ste 160
Shakopee, MN 55379-2863
Mailing address
4201 Dean Lakes Blvd Ste 160
Shakopee, MN 55379-2863
Phone (612) 509-6681
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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 20, 2022. 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.