Individual
ENTESAR ADEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1710 DOUGLAS DR N STE 225E, GOLDEN VALLEY, MN 55422-4363
(763) 496-8869
Mailing address
12051 NORWAY ST NW, COON RAPIDS, MN 55448-2243
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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