Individual
ALYSSA MARIE SHAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 ROUND LAKE BLVD NW, ANOKA, MN 55303-3315
(612) 509-7113
Mailing address
12438 67TH CT NE, OTSEGO, MN 55330-6705
(612) 364-4555
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MN
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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