Individual
RIVER-JEANETTE MONIQUE EZEOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPRS
Contact information
Practice address
2511 CROIXWOOD BLVD, STILLWATER, MN 55082
(612) 601-4549
Mailing address
PO BOX 343, WILLERNIE, MN 55090-0343
(612) 601-4549
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
8661
MN
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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