Individual
CHARLIE YANISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
540 E 1ST ST, WACONIA, MN 55387-1600
(952) 442-4437
(952) 442-3084
Mailing address
540 E 1ST ST, WACONIA, MN 55387-1600
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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