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NPI Code Detail

MEDICARE: KALASIA CHYNNA MONA JABBRIA HOWARD

MEDICARE: KALASIA CHYNNA MONA JABBRIA HOWARD
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
1106S00000XBehavior Technician
2374J00000XDoulaDOUL-284MN

General Provider Information

NPI Number : 1619638467
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALASIA CHYNNA MONA JABBRIA HOWARD
Provider Business Mailing Address
First Line : 1121 JACKSON ST NE STE 100
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-3051
Country : US
Telephone Number : 612-353-6293
Fax Number : 612-353-6437
Provider Business Practice Location Address
First Line : 1121 JACKSON ST NE STE 100
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-3051
Country : US
Telephone Number : 612-353-6293
Fax Number : 612-353-6437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2022
Last Update Date : 08/13/2025

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