Individual
ABIGIA SAMSON TADESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 DEAN LAKES BLVD STE 160, SHAKOPEE, MN 55379-2863
(612) 509-6681
Mailing address
834 PROVIDENCE DR, SHAKOPEE, MN 55379-4459
(651) 206-4063
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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