Individual provider · Type 1 NPI

Tanya Medina Vassallo, MA, LBA, BCBA

Behavior Analyst · Plymouth, MN

NPI number 1740932508 Active

Practice location

5010 Cheshire Ln N Ste 1
Plymouth, MN 55446-3863

Call (612) 439-4650 Map

Mailing address

6233 Russell Ave S
Richfield, MN 55423-1003

Specialties and licenses

Taxonomy	Code	License
Behavior Analyst Primary	103K00000X	LBA0719 (MN)

Behavior Analyst: A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis…

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About NPI 1740932508

Tanya Medina Vassallo, MA, LBA, BCBA's National Provider Identifier is 1740932508, issued on Jan 24, 2022. The primary taxonomy on file is Behavior Analyst (103K00000X), and the practice location is in Plymouth, MN. The record was last updated on Jan 8, 2026.