(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003549676
Provider Name: KHALEDA ISLAM
Entity Type: Individual
Taxonomy Code: 106S00000X
Specialty: Behavior Technician
License Number:
Most Important Dates
Enumeration Date: 07/01/2022
Last Updated: 09/06/2022
Provider Practice Location
7615 GOLDEN TRIANGLE DR STE A
EDEN PRAIRIE
MN
553443733
Practice Location Phone/Fax
Phone: 6127677222
Fax:
Provider Mailing Location
17350 BAINBRIDGE DR
EDEN PRAIRIE
MN
553472295
Provider Mailing Phone/Fax
Phone: 6519556486
Fax: