Individual
MRS. DANETTA LAVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL/CBIS
Contact information
Practice address
559 CAPITOL BLVD, SAINT PAUL, MN 55103-2101
(651) 232-2128
Mailing address
559 CAPITOL BLVD, SAINT PAUL, MN 55103-2101
(651) 232-2128
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
101119
MN
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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