Individual
ASHA WAKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 AMERICAN BLVD E STE 5A, BLOOMINGTON, MN 55425-1152
(612) 401-1173
(952) 487-2610
Mailing address
1325 AMERICAN BLVD E STE 5A, BLOOMINGTON, MN 55425-1152
(612) 401-1173
(952) 487-2610
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
D604058443910
MN
Other
Enumeration date
11/29/2024
Last updated
11/29/2024
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