Individual
AUDRIELLE JUNE MOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4140 RICHARD AVE STE 200&300, HERMANTOWN, MN 55811-2869
(218) 514-5230
Mailing address
1575 ALLOUEZ AVE, GREEN BAY, WI 54311-5625
(218) 514-5230
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-24-75781
MN
106E00000X
Assistant Behavior Analyst
0-24-14972
MN
106S00000X
Behavior Technician
RBT-21-182674
CO
Other
Enumeration date
10/21/2021
Last updated
02/07/2026
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