Individual
MARISSA LAUREL STORDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
5654 GARDEN HILLS LN, SAINT CLOUD, MN 56301-3412
(320) 491-4768
Mailing address
5654 GARDEN HILLS LN, SAINT CLOUD, MN 56301-3412
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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