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Individual

WORKINESH ABDELLA WOTICHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
493 AURORA AVE, SAINT PAUL, MN 55103-2218
(651) 855-8048
(651) 621-7732
Mailing address
493 AURORA AVE, SAINT PAUL, MN 55103-2218
(651) 855-8048
(651) 621-7732

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
1101666
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A773910000
DHS
MN
Enumeration date
05/14/2020
Last updated
05/14/2020
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