Individual
ESTELLA JISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 MEADOWLANDS DR, WHITE BEAR LAKE, MN 55127-2339
(612) 445-0300
Mailing address
4985 EVERGREEN DR N UNIT 4, HUGO, MN 55038-8574
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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