Individual
MRS. SHANNON DAWN ROLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2039 153RD AVE, MORA, MN 55051-7457
(320) 679-5272
Mailing address
2039 153RD AVE, MORA, MN 55051-7457
(320) 679-5272
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
1057883-1-AFC
MN
Other
Enumeration date
07/08/2010
Last updated
07/08/2010
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