Panda Thammavong, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3721 23Rd St S Ste 201
Saint Cloud, MN 56301-6199

Phone

(605) 271-2690

Fax

(605) 271-3956

NPI assigned

May 27, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1538909841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 W RUSSELL ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571041322",
            "telephone_number": "605-271-2690",
            "fax_number": "605-271-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3721 23RD ST S STE 201",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563016199",
            "telephone_number": "605-271-2690",
            "fax_number": "605-271-3956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Dean Lakes Blvd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Shakopee",
            "state": "MN",
            "postal_code": "553792863",
            "country_code": "US",
            "telephone_number": "612-416-1301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAMMAVONG",
        "first_name": "PANDA",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-27",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Terhaar
• Melinda Terhaar, LICSW
• Terrence Murphy PA
• John M Teskey, MD
• Morgan Tetley
• Augustine Thapa Tamang
• Melanie Jo Lirong Thares, OD
• Nicholas Thayer
• The Saint Cloud Hospital
• The Wellness Clinic L.L.C.

• Behavior Technician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.