Individual
MRS. BOBBI JEAN WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.C.B.A.
Contact information
Practice address
327 5TH AVE SE, DOVER, MN 55929-1415
(715) 797-8702
Mailing address
327 5TH AVE SE, DOVER, MN 55929-1415
(715) 797-8702
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-11583
MN
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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