Individual
WANDA HOUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1112 14TH AVE SE, SAINT CLOUD, MN 56304-1742
(320) 229-8758
(320) 259-7837
Mailing address
1112 14TH AVE SE, SAINT CLOUD, MN 56304-1742
(320) 229-8758
(320) 259-7837
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1034669-3-AFC
MN
Other
Enumeration date
07/23/2009
Last updated
07/23/2009
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