Individual
ELLIE SWALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 MEADOWLANDS DR STE 1, WHITE BEAR LAKE, MN 55127-2340
(612) 445-0300
Mailing address
574 VICKI LN, SHOREVIEW, MN 55126-4775
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/06/2023
Last updated
06/06/2023
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