Individual
JAMIE WALDVOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1570 LOIS DR, SHOREVIEW, MN 55126-8582
(612) 224-1051
Mailing address
1570 LOIS DR, SHOREVIEW, MN 55126-8582
(612) 224-1051
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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