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: |