Individual
ANDRAYA THERESE PARENTEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14445 COUNTY HIGHWAY 5, LAKE PARK, MN 56554-9121
(701) 893-8166
Mailing address
1720 BASSETT DR, MANKATO, MN 56001-6569
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZCY267454611261
BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA
—
Enumeration date
05/20/2020
Last updated
05/20/2020
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