Individual
JEANNINE KATHERINE MYRVIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-5618
(651) 241-7168
Mailing address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-5618
(651) 241-7168
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15374
MN
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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