Individual
DENAE MORYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10450 185TH ST W, LAKEVILLE, MN 55044-6686
(612) 509-6690
Mailing address
501 MADISON AVE, MANKATO, MN 56001-6109
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
02/18/2022
Last updated
02/21/2022
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