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Individual

ELLIE MARGARET PRENZLOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
731 BIELENBERG DR STE 102-104, WOODBURY, MN 55125-1700
(602) 820-7679
Mailing address
610 JESSAMINE AVE E APT 2, SAINT PAUL, MN 55130-3745
(612) 220-0523

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
05/06/2024
Last updated
05/06/2024
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