Individual
ANGELA BUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW LICSW CCTP
Contact information
Practice address
4720 BURNING TREE RD, DULUTH, MN 55811-2634
(218) 623-1812
Mailing address
4720 BURNING TREE RD, DULUTH, MN 55811-2634
(218) 623-1812
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
70479
CA
1041C0700X
Clinical Social Worker
Primary
29234
MN
1041C0700X
Clinical Social Worker
9995123
WI
Other
Enumeration date
02/09/2015
Last updated
08/05/2022
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