Individual
MARY ROSE NETTLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
7362 UNIVERSITY AVE NE, SUITE 209, FRIDLEY, MN 55432-3142
(612) 825-4407
(612) 825-0768
Mailing address
3108 HENNEPIN AVE, MINNEAPOLIS, MN 55408-2619
(612) 825-4407
(612) 825-0768
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10269
MN
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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