Provider Demographics
NPI:1760375398
Name:ADAM, SULEKHA
Entity type:Individual
Prefix:
First Name:SULEKHA
Middle Name:
Last Name:ADAM
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 1:12281 RIVER VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-1225
Mailing Address - Country:US
Mailing Address - Phone:612-701-2568
Mailing Address - Fax:
Practice Address - Street 1:14041 BURNHAVEN DR STE 150
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4442
Practice Address - Country:US
Practice Address - Phone:952-500-2206
Practice Address - Fax:612-234-6566
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician