NPI 1003485467

Lydia Shull

Practitioner Behavior Technician Minneapolis, MN

Practice location

Address: 3333 University Ave SE, Minneapolis, MN 55414-3325
Phone: (612) 331-9413
Mailing address: 4839 305th Ave NE, Cambridge, MN 55008-6707

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Registry record

NPI: 1003485467
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Jun 2021
Record last updated: 21 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.