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Individual

MR. MITCHELL GRANT HAYLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
722 FIFTEENTH STREET NW, BEMIDJI, MN 56601
(218) 751-3280
Mailing address
16166 WILKEY LOOP RD NE, BEMIDJI, MN 56601-6417
(218) 444-7148

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
09/28/2006
Last updated
07/08/2007
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