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1982376026
MIRANDA MARIE DEATLEY
MANKATO, MN
NPI
1982376026
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Additional Taxonomies
251S00000X
Enumeration Date
2021-09-28
Last Update Date
2021-09-28
Business Address
MIRANDA MARIE DEATLEY
501 MADISON AVE
MANKATO, MN 56001-6109
Phone number: 507-682-7100
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Mailing Address
MIRANDA MARIE DEATLEY
1746 PLEASANT VIEW DR
NORTH MANKATO, MN 56003-1616
Phone number: 507-381-3321
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