Individual
ALENA RENEE LAVASTIDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3325
(612) 767-7222
Mailing address
3333 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3325
(612) 767-7222
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/17/2022
Last updated
01/17/2022
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