Individual
MR. ALAN M. LISTIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1516 W LAKE ST, SUITE 103, MINNEAPOLIS, MN 55408-2554
(612) 822-1357
(612) 822-1360
Mailing address
2712 FREMONT AVE S, MINNEAPOLIS, MN 55408-1122
(612) 822-1357
(612) 822-1360
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7767
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
03/22/2007
Last updated
07/08/2007
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