Provider Demographics
NPI:1083430698
Name:ABERA, REDIET TEWODROS
Entity type:Individual
Prefix:
First Name:REDIET
Middle Name:TEWODROS
Last Name:ABERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 UNIVERSITY AVE W STE 210
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1698
Mailing Address - Country:US
Mailing Address - Phone:651-502-2945
Mailing Address - Fax:
Practice Address - Street 1:2233 UNIVERSITY AVE W STE 210
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1698
Practice Address - Country:US
Practice Address - Phone:651-502-2945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst