Individual
DECONTEE TEAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12915 63RD AVE N, MAPLE GROVE, MN 55369-6001
(952) 767-4200
Mailing address
5868 BAKER RD, MINNETONKA, MN 55345-5903
(952) 767-4200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
MN
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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