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Individual

ELIZABETH ANN BOEGEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LICSW, LADC

Contact information

Practice address
2530 CHICAGO AVE # CSC-175, MINNEAPOLIS, MN 55404-4289
(612) 813-6458
Mailing address
2530 CHICAGO AVE # CSC-175, MINNEAPOLIS, MN 55404-4289

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304124
MN
1041C0700X
Clinical Social Worker
Primary
26472
MN

Other

Enumeration date
04/23/2021
Last updated
04/23/2021
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