Individual
CHELSEANNE LUELLA DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3395 PLYMOUTH RD, MINNETONKA, MN 55305-3765
(952) 939-0396
Mailing address
5635 314TH ST, STACY, MN 55079-9559
(651) 307-2351
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/11/2018
Last updated
12/06/2018
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