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1053038299
LARRY JAYDEN BALES
BURNSVILLE, MN
NPI
1053038299
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-10-27
Last Update Date
2022-10-27
Business Address
LARRY JAYDEN BALES
427 WEST TRAVELERS TRAIL
BURNSVILLE, MN 55337
Phone number: 952-247-2954
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Mailing Address
LARRY JAYDEN BALES
427 WEST TRAVELERS TRAIL
BURNSVILLE, MN 55337
Phone number: 952-247-2954
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