Individual
ELIZABETH HUBBARD BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1619 DAYTON AVE, SUITE 110, SAINT PAUL, MN 55104-6206
(651) 523-8800
(651) 523-8811
Mailing address
1619 DAYTON AVE, SUITE 110, SAINT PAUL, MN 55104-6206
(651) 523-8800
(651) 523-8811
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
09797
MN
1041C0700X
Clinical Social Worker
Primary
09797
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55G76BR
BLUE CROSS/BLUE SHIELD
MN
Enumeration date
09/22/2006
Last updated
02/19/2008
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