Individual
ASHLEY KRISTINE EDEN HALTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3007 HARBOR LN N STE 1200, MINNEAPOLIS, MN 55447-5138
(612) 439-4650
Mailing address
11701 CENTRAL PARK WAY APT 1276, MAPLE GROVE, MN 55369-3123
(661) 768-8025
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1546354179
TRICARE
—
Enumeration date
01/22/2025
Last updated
01/22/2025
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