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1225549520
PENNY GILLEN
OTSEGO, MN
NPI
1225549520
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-10-13
Last Update Date
2017-10-13
Business Address
PENNY GILLEN
9245 QUANTRELLE AVE NE
OTSEGO, MN 55330-0168
Phone number: 763-746-9492
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Mailing Address
PENNY GILLEN
1900 SILVER LAKE RD NW
NEW BRIGHTON, MN 55112-1786
Phone number:
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