Individual
GIRMA DUFERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14511 LOCKSLIE TRL, SAVAGE, MN 55378-2257
(612) 517-8429
Mailing address
14511 LOCKSLIE TRL, SAVAGE, MN 55378-2257
(612) 517-8429
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
1110719
MN
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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