Individual
BRENDA KAY CICCONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-7177
Mailing address
5503 RICHMOND CURV, MINNEAPOLIS, MN 55410-2535
(612) 920-3603
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
102253
MN
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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