Healthcare Provider Details

I. General information

NPI: 1700775491
Provider Name (Legal Business Name): ALAYNA MUSSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date: 04/02/2026
Reactivation Date: 07/16/2026

III. Provider practice location address

100 MAIN ST S
MINOT ND
58701-3914
US

IV. Provider business mailing address

100 MAIN ST S
MINOT ND
58701-3914
US

V. Phone/Fax

Practice location:
  • Phone: 701-809-0189
  • Fax:
Mailing address:
  • Phone:
  • 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: