Most Relevant Information
Provider Data
| NPI Number: | 1003532508 |
| Provider Name: | MICAH ALICIA HERNDON |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/17/2022 |
| Last Updated: | 10/17/2022 |
Provider Practice Location
3333 UNIVERSITY AVE SE
MINNEAPOLIS
MN
554143325
Practice Location Phone/Fax
| Phone: | 2015893367 |
| Fax: |
Provider Mailing Location
3333 UNIVERSITY AVE
MINNEAPOLIS
MN
554142305
Provider Mailing Phone/Fax
| Phone: | 6123319413 |
| Fax: |