Individual
CARYLEE EATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
10080 99TH AVE N, MAPLE GROVE, MN 55369-3829
(503) 544-6397
Mailing address
10080 99TH AVE N, MAPLE GROVE, MN 55369-3829
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
13688
SC
1041C0700X
Clinical Social Worker
Primary
27115
MN
1041C0700X
Clinical Social Worker
L1736
OR
Other
Enumeration date
12/06/2020
Last updated
12/06/2020
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