Jacqueline Irene Andren
Individual provider Active NPI Behavior Technician · Moorhead, MN
NPI 1356224760 · NPPES record last updated Jul 31, 2025
Key facts
- NPI
- 1356224760
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 1530 1St Ave N Ste 150
Moorhead, MN 56560-0002 - Phone
- (218) 275-6602
- NPI assigned
- Jul 31, 2025
- 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
1530 1St Ave N Ste 150
Moorhead, MN 56560-0002
Mailing address
1530 1St Ave N Ste 150
Moorhead, MN 56560-0002
Phone (218) 275-6602
Other providers in Moorhead, MN
- Michelle Lynn Anderson
- Nicole Anderson
- Skyler David Anderson
- Tom G. Anderson
- Tyra Anderson
- Stanton L Andrist
- Mickenna Ansell
- Lynne Rita Anseth
- Kristin Appel
- Arbor Park Village, LLC
All providers in Moorhead, 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 31, 2025. 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.