Wafaa Hassan Mohamed

Individual provider Active NPI Behavior Technician · Golden Valley, MN

NPI 1447046529 · NPPES record last updated Apr 16, 2025

Key facts

NPI
1447046529
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-22-229328 (IN)
Practice address
1405 Lilac Dr N Ste 215
Golden Valley, MN 55422-4546
Phone
(314) 601-5744
NPI assigned
Apr 16, 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

State licenses

LicenseStateTypeSpecialty
RBT-22-229328INMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-22-229328 IN Yes

Addresses

Primary practice location

1405 Lilac Dr N Ste 215
Golden Valley, MN 55422-4546

Mailing address

1405 Lilac Dr N Ste 215
Golden Valley, MN 55422-4546

Other providers in Golden Valley, MN

All providers in Golden Valley, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.