Individual
ALICIA ANN VANDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
2345 ARIEL ST N, MAPLEWOOD, MN 55109-2248
(651) 254-4793
(651) 254-0877
Mailing address
2345 ARIEL ST N, MAPLEWOOD, MN 55109-2248
(651) 254-4793
(651) 254-0877
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15924
MN
Other
Enumeration date
09/21/2014
Last updated
09/21/2014
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