Individual
MRS. EMILY KATHRYN BROVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 COBBLESTONE LN, BURNSVILLE, MN 55337-4578
(952) 953-5364
Mailing address
26 9TH AVE SE, FARIBAULT, MN 55021-6302
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
103742
MN
Other
Enumeration date
06/16/2009
Last updated
12/20/2010
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