Individual
CLARIBELL EZENNIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1240 3RD AVE E STE 100, SHAKOPEE, MN 55379-1679
(952) 777-4996
Mailing address
1240 3RD AVE E STE 100, SHAKOPEE, MN 55379-1679
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/05/2025
Last updated
09/11/2025
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