Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | ||
N | 225400000X | Rehabilitation Practitioner |
NPI | 1013531482 |
---|---|
Provider Name | Emilee Morrison |
First Address | Burnsville, MN 55306-6945 |
Second Address | Winona, MN 55987-3595 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2020 |
Last Update Date | 20/10/2020 |