Ingrid Sulistyo
NPI #1053901116 in Mendota Heights, Minnesota
Provider Information
- NPI Number
- 1053901116
- Entity Type
- Individual
- Name
- Ingrid Sulistyo
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Jan 22, 2021
- Last Updated
- Jan 22, 2021
Practice Location
- Address
- 2060 CENTRE POINTE BLVD STE 3
- City
- Mendota Heights
- State
- Minnesota
- ZIP Code
- 55120-1271
- Phone
- (866) 822-7464
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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