Individual
KATHLEEN JOAN LYTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
451 DUNLAP ST N, SAINT PAUL, MN 55104-4619
(651) 647-2116
(651) 647-2201
Mailing address
451 DUNLAP ST N, SAINT PAUL, MN 55104-4619
(651) 647-2116
(651) 647-2201
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2622
MN
Other
Enumeration date
05/27/2010
Last updated
05/27/2010
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