Individual
ALIJAH MICHELLE ISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14387 EDGEWOOD DR, BAXTER, MN 56425-8460
(218) 454-5181
Mailing address
14387 EDGEWOOD DR, BAXTER, MN 56425-8460
(218) 454-5181
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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