Individual
MS. CORIE SHARON KOTANSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1313 5TH ST SE STE 208D, MINNEAPOLIS, MN 55414-4502
(612) 721-3318
(612) 379-2511
Mailing address
1313 5TH ST SE STE 208D, MINNEAPOLIS, MN 55414-4502
(612) 721-3318
(612) 379-2511
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15218
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01025895
PREFERRED ONE
MN
01
—
063L9KO
BLUE CROSS BLUE SHIELD
MN
01
—
62 62359
UBH MEDICA
MN
Enumeration date
12/20/2006
Last updated
07/08/2007
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