Individual
ANISA ADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1405 SILVER LAKE RD NW STE 9, NEW BRIGHTON, MN 55112-9312
(612) 501-1363
Mailing address
1405 SILVER LAKE RD NW STE 9, NEW BRIGHTON, MN 55112-9312
(612) 501-1363
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/12/2025
Last updated
07/12/2025
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