Individual
ALYSSA MAE KOKTAVY ISRAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LGSW
Contact information
Practice address
10248 E OLSON RD, COOK, MN 55723-8184
(218) 666-5221
Mailing address
116 12TH ST S, VIRGINIA, MN 55792-2918
(507) 581-2510
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
34288
MN
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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