Individual
EMILY S SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 CENTRE POINTE DR STE 7, MENDOTA HEIGHTS, MN 55120-1377
(952) 401-9359
Mailing address
1160 CENTRE POINTE DR STE 7, MENDOTA HEIGHTS, MN 55120-1377
(952) 401-9359
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
03/28/2022
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