Ilyas Adan
Individual provider Active NPI Behavior Technician · Faribault, MN
NPI 1831968791 · NPPES record last updated Dec 20, 2023
Key facts
- NPI
- 1831968791
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 201 Lyndale Ave S Ste L3
Faribault, MN 55021-5758 - Phone
- (612) 707-1718
- NPI assigned
- Dec 20, 2023
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
201 Lyndale Ave S Ste L3
Faribault, MN 55021-5758
Mailing address
201 Lyndale Ave S Ste L3
Faribault, MN 55021-5758
Other providers in Faribault, MN
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- Suad Ahmed Adam
- Fatuma Adan
- Kelsi Addabbo
- Abdullahi Aden
- Fardosa Aden
- Ibrahim Aden
- Ruweyda Aden
All providers in Faribault, 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 Dec 20, 2023. 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.