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NPI Code Detail

MEDICARE: TESA T DAHL MS, BCBA, LBA

MEDICARE: TESA T DAHL MS, BCBA, LBA
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
1103K00000XBehavior Analyst1-04-2050

General Provider Information

NPI Number : 1942582614
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESA T DAHL MS, BCBA, LBA
Provider Business Mailing Address
First Line : 25805 190TH ST
Second Line :
City : GLENWOOD
State : MN
Zip : 56334-3414
Country : US
Telephone Number : 760-809-7538
Fax Number :
Provider Business Practice Location Address
First Line : 59 GLENN RD NW
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-4007
Country : US
Telephone Number : 320-219-7644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2011
Last Update Date : 05/22/2026

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