Individual
ANGELA SANDELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30849 1ST ST, PEQUOT LAKES, MN 56472-2767
(218) 839-1895
(218) 568-1097
Mailing address
PO BOX 852, PEQUOT LAKES, MN 56472-0852
(218) 839-1895
(218) 568-1097
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
396510
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
396510
COMPREHENSIVE HOME CARE LICENSE
MN
Enumeration date
04/05/2021
Last updated
04/05/2021
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