Individual
CALLIE J HENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
314 10TH AVE S # 100, WAITE PARK, MN 56387-1400
(320) 200-1342
Mailing address
53180 397TH ST, PAYNESVILLE, MN 56362-9501
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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