Individual
MRS. ALBERTA WINNIFRED DESOUZA ADDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6220 W 132ND ST, SAVAGE, MN 55378-2484
(952) 215-9206
Mailing address
6220 W 132ND ST, SAVAGE, MN 55378-2484
(952) 215-9206
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1088299-1-HCBS
DHS-245D
MN
Enumeration date
01/22/2018
Last updated
01/22/2018
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