MEDICARE: ZAYON MARYAN OMBUNA

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
1	106S00000X	Behavior Technician		MN

General Provider Information

NPI Number	:	1326990342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAYON MARYAN OMBUNA

Provider Business Mailing Address
First Line	:	1911 NICOLLET AVE STE 1
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-3747
Country	:	US
Telephone Number	:	612-323-3880
Fax Number	:	612-777-0570

Provider Business Practice Location Address
First Line	:	1911 NICOLLET AVE STE 1
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-3747
Country	:	US
Telephone Number	:	612-323-3880
Fax Number	:	612-777-0570

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ ZAYON MARYAN OMBUNA ” Practice Location

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