Individual
AYAN IDLE HARET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4640 SLATER RD STE 100, EAGAN, MN 55122-4044
(612) 412-3318
Mailing address
121 HENNEPIN AVE, MINNEAPOLIS, MN 55401-1802
(612) 412-3318
(612) 288-1805
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/03/2025
Last updated
05/03/2025
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