Mallory Buttrick
Individual provider Active NPI Behavior Technician · Hermantown, MN
NPI 1619857794 · NPPES record last updated Sep 8, 2025
Key facts
- NPI
- 1619857794
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 4140 Richard Ave
Suites 200 and 300
Hermantown, MN 55811-2869 - Phone
- (218) 520-3411
- NPI assigned
- Sep 8, 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
4140 Richard Ave
Suites 200 and 300
Hermantown, MN 55811-2869
Mailing address
4140 Richard Ave Ste And300
Hermantown, MN 55811-2869
Other providers in Hermantown, MN
- Mark John Bruzek
- Eva Lauren Bucci
- Amanda Buchanan
- Brittnee Rae Budde
- Alexander J Burrwig
- Vanessa Rose Carey
- Caringedge Healthcare of Hermantown LLC
- Caringedge Hospice of Hermantown LLC
- Michelle L Carl
- Darlene Evelyn Carlson
All providers in Hermantown, 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 Sep 8, 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.