Healthcare Provider Details

I. General information

NPI: 1740026319
Provider Name (Legal Business Name): WALAA ESSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 SUPERIOR DR NW STE 101
ROCHESTER MN
55901-1775
US

IV. Provider business mailing address

1470 INDUSTRIAL DR NW
ROCHESTER MN
55901-0700
US

V. Phone/Fax

Practice location:
  • Phone: 952-212-0358
  • Fax: 612-326-6160
Mailing address:
  • Phone: 507-353-3023
  • 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: