Abase Abase
Individual provider Active NPI Behavior Technician · Burnsville, MN
NPI 1417740424 · NPPES record last updated May 23, 2025
Key facts
- NPI
- 1417740424
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 11972 Portland Ave
Burnsville, MN 55337-1516 - Phone
- (952) 658-8670
- NPI assigned
- May 23, 2025
- Sex
- Male
- Sole proprietor
- Yes
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
11972 Portland Ave
Burnsville, MN 55337-1516
Mailing address
11972 Portland Ave
Burnsville, MN 55337-1516
Phone (952) 658-8670
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All providers in Burnsville, 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 May 23, 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.