Mohamed Isse

Individual provider Active NPI Behavior Technician · St.Paul, MN

NPI 1598520728 · NPPES record last updated Feb 16, 2024

Key facts

NPI
1598520728
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2361 Highway 36 W
Ste 200
St.Paul, MN 55113
Phone
(952) 994-0909
NPI assigned
Feb 16, 2024
Sex
Male
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

2361 Highway 36 W
Ste 200
St.Paul, MN 55113

Mailing address

2361 Highway 36 W
Ste 200
St.Paul, MN 55113

Other providers in St.Paul, MN

All providers in St.Paul, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.