Most Relevant Information
Provider Data
| NPI Number: | 1003485467 |
| Provider Name: | LYDIA SHULL |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/21/2021 |
| Last Updated: | 06/21/2021 |
Provider Practice Location
3333 UNIVERSITY AVE SE
MINNEAPOLIS
MN
554143325
Practice Location Phone/Fax
| Phone: | 6123319413 |
| Fax: |
Provider Mailing Location
4839 305TH AVE NE
CAMBRIDGE
MN
550086707
Provider Mailing Phone/Fax
| Phone: | 7632801238 |
| Fax: |