Individual
JOSEPHINE FUDALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1308 GREENWOOD CT, SHAKOPEE, MN 55379-4452
(512) 458-0260
Mailing address
4757 HIAWATHA AVE UNIT 607, MINNEAPOLIS, MN 55406-4491
(715) 817-3768
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/25/2020
Last updated
07/12/2023
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