Individual
DALESO YADETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
11850 BLACKFOOT ST NW STE 100, COON RAPIDS, MN 55433-2774
(763) 712-2100
(763) 712-2190
Mailing address
2550 UNIVERSITY AVE W STE 110N, SAINT PAUL, MN 55114-2001
(651) 602-5311
(651) 222-6786
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12817
MN
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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