Hani Mohamed Ali

Individual provider Active NPI Behavior Technician · Shakopee, MN

NPI 1316620610 · NPPES record last updated Oct 11, 2023

Key facts

NPI
1316620610
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
4201 Dean Lakes Blvd Ste B
Shakopee, MN 55379-2829
Phone
(612) 509-6681
NPI assigned
Aug 11, 2023
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

4201 Dean Lakes Blvd Ste B
Shakopee, MN 55379-2829

Mailing address

4201 Dean Lakes Blvd Ste B
Shakopee, MN 55379-2829
Phone (612) 509-6681

Other providers in Shakopee, MN

All providers in Shakopee, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.