Individual
LILLIANA IRENE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7615 GOLDEN TRIANGLE DR STE A, EDEN PRAIRIE, MN 55344-3733
(952) 767-2974
Mailing address
6734 STATE HIGHWAY 25 SW, MONTROSE, MN 55363-8520
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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