Provider Demographics
NPI:1881087781
Name:ROBEDNA BEHAVIORAL CONSULTING
Entity type:Organization
Organization Name:ROBEDNA BEHAVIORAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUD
Authorized Official - Middle Name:SELASIE
Authorized Official - Last Name:DOGOE ANKUDEY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:320-227-2602
Mailing Address - Street 1:3600 W SAINT GERMAIN ST
Mailing Address - Street 2:267
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-4633
Mailing Address - Country:US
Mailing Address - Phone:320-227-2602
Mailing Address - Fax:
Practice Address - Street 1:3600 W SAINT GERMAIN ST
Practice Address - Street 2:267
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4633
Practice Address - Country:US
Practice Address - Phone:320-227-2602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty