Individual
KATELYN SARAH KUBISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
10000 HWY 55 STE 200, PLYMOUTH, MN 55441-6433
(586) 707-7085
Mailing address
976 PACIFIC ST, SAINT PAUL, MN 55106-6324
(586) 707-7085
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
31140
MN
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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