Individual
JUSTIN W SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
750 S PLAZA DR STE 100, MENDOTA HEIGHTS, MN 55120-1505
(612) 227-9014
(651) 455-1385
Mailing address
4720 GRAND AVE S UNIT 2, MINNEAPOLIS, MN 55419-5430
(612) 227-9014
(651) 455-1385
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
22271
MN
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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