Individual
MR. JOSEPH JOHN WITTENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
11220 CROCUS ST NW, COON RAPIDS, MN 55433
(763) 767-4702
Mailing address
11220 CROCUS ST NW, COON RAPIDS, MN 55433
(763) 767-4702
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15449
MN
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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