Most Relevant Information
Provider Data
| NPI Number: | 1003522368 |
| Provider Name: | MISKE ADAN JAMA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/30/2023 |
| Last Updated: | 01/31/2023 |
Provider Practice Location
1801 AMERICAN BLVD E STE 8
BLOOMINGTON
MN
554251230
Practice Location Phone/Fax
| Phone: | 6123319413 |
| Fax: |
Provider Mailing Location
9319 4TH AVE S
BLOOMINGTON
MN
554203723
Provider Mailing Phone/Fax
| Phone: | 6125013537 |
| Fax: | 6125013537 |