Individual
ELLIE BLAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3721 23RD ST S STE 201, SAINT CLOUD, MN 56301-6199
(218) 457-2185
(605) 271-3956
Mailing address
1105 W RUSSELL ST, SIOUX FALLS, SD 57104-1322
(605) 271-2690
(605) 271-3956
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-162709
MN
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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