Individual
BAZEN TESFAYE LEUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2233 UNIVERSITY AVE W, SAINT PAUL, MN 55114-1600
(720) 519-9476
Mailing address
2233 UNIVERSITY AVE W STE 210, SAINT PAUL, MN 55114-1698
(720) 519-9476
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/02/2024
Last updated
12/23/2024
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