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Individual

DEJA MONET COLEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3007 HARBOR LN N, PLYMOUTH, MN 55447-5103
(612) 445-8314
Mailing address
5908 2 1/2 ST NE APT 4, FRIDLEY, MN 55432-5588

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103K0000X
BCBA
MN
Enumeration date
08/09/2021
Last updated
08/09/2021
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