Gina Rose Goettl

Individual provider Active NPI Behavior Technician · North Mankato, MN

NPI 1376409383 · NPPES record last updated Jan 3, 2026

Key facts

NPI
1376409383
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2101 Rolling Green Lane
North Mankato, MN 56003
Phone
(952) 767-4200
Fax
(952) 767-4211
NPI assigned
Jan 3, 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

2101 Rolling Green Lane
North Mankato, MN 56003

Mailing address

5868 Baker Rd
Minnetonka, MN 55345
Phone (952) 767-4200

Other providers in North Mankato, MN

All providers in North Mankato, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.