Individual
ANNIE WEAH CLINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
819 38TH AVE, ANOKA, MN 55303-1225
(612) 225-8750
Mailing address
819 38TH AVE, ANOKA, MN 55303-1225
(612) 225-8750
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/21/2025
Last updated
06/10/2025
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