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NPI Code Detail

MEDICARE: BRIDGE ABA

MEDICARE: BRIDGE ABA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1252Y00000XEarly Intervention Provider Agency

General Provider Information

NPI Number : 1003704511
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRIDGE ABA
Provider Business Mailing Address
First Line : 8400 NORMANDALE LAKE BLVD STE 920
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55437-3843
Country : US
Telephone Number : 206-338-2497
Fax Number : 206-848-5275
Provider Business Practice Location Address
First Line : 8400 NORMANDALE LAKE BLVD STE 920
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55437-3843
Country : US
Telephone Number : 206-338-2497
Fax Number : 206-848-5275
Authorized Official
Title or Position : MANAGER
Name : MS. YASMIN ABDULRISAK IGAL
Credential :
Telephone Number : 206-338-2479
Provider Enumeration Date : 06/24/2025
Last Update Date : 06/24/2025

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Directions to “BRIDGE ABA ” Practice Location

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