Jaden Thomas Northup

NPI #1013614254 in Stillwater, Minnesota

Provider Information

NPI Number: 1013614254
Entity Type: Individual
Name: Jaden Thomas Northup
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Feb 8, 2023
Last Updated: Feb 8, 2023

Practice Location

Address: 1701 CURVE CREST BLVD W STE 104
City: Stillwater
State: Minnesota
ZIP Code: 55082-6181
Phone: (651) 342-1883

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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