Individual
BRIANNA LARISSA JUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
ST. CLOUD HOSPITAL, 1406 6TH AVENUE N, ST. CLOUD, MN 56303
(320) 251-2700
Mailing address
10856 BLUEBIRD ST NW, COON RAPIDS, MN 55433-4292
(763) 744-7971
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10079
MN
Other
Enumeration date
06/22/2018
Last updated
03/28/2019
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