Individual
AUTUMN ALISE CAVENDER-WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.P.M., L.T.M
Contact information
Practice address
2643 540TH ST, GRANITE FALLS, MN 56241-3625
(320) 444-5645
Mailing address
2643 540TH ST, GRANITE FALLS, MN 56241-3625
(320) 444-5645
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
1042
MN
Other
Enumeration date
02/09/2015
Last updated
02/09/2015
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