Individual
KAITLYN ROSE PSCODNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LGSW, RDN, CSSD
Contact information
Practice address
7052 ABRAHAMSON RD, LUDINGTON, MI 49431-8800
(612) 405-4251
Mailing address
7052 ABRAHAMSON RD, LUDINGTON, MI 49431-8800
(612) 405-4251
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
33848
MN
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33848
LICENSED GRADUATE SOCIAL WORKER
MN
Enumeration date
06/29/2021
Last updated
12/19/2024
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