Healthcare Provider Details

I. General information

NPI: 1699608430
Provider Name (Legal Business Name): ARIELLE DUDUNDANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7133 116TH PL N
CHAMPLIN MN
55316-2879
US

IV. Provider business mailing address

2651 COUNTY ROAD H2 APT 212
SAINT PAUL MN
55112-4789
US

V. Phone/Fax

Practice location:
  • Phone: 612-252-2366
  • Fax:
Mailing address:
  • Phone: 612-251-2366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: