Individual
AINSLEY GRACE DITLEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14301 EWING AVE S, BURNSVILLE, MN 55306-4885
(952) 746-5350
Mailing address
833 OVERLOOK PL, EAGAN, MN 55123-2295
(612) 817-4945
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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