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Individual

AMANDA MARIE O'CONNOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
1240 3RD AVE E STE 100, SHAKOPEE, MN 55379-1679
(952) 777-4996
(952) 777-2004
Mailing address
1249 RUBY LN, SHAKOPEE, MN 55379-3356
(651) 273-3915

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
MN

Other

Enumeration date
06/22/2021
Last updated
06/22/2021
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