Individual
KATY KIM ARMENDARIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3405 CHICAGO AVE, MINNEAPOLIS, MN 55407-2107
(612) 710-2797
Mailing address
5724 36TH AVE S, MINNEAPOLIS, MN 55417-2908
(612) 710-2797
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19837
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800003275
MEDICARE INDIVIDUAL PTAN
MN
Enumeration date
08/21/2012
Last updated
11/25/2013
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