Organization
ISUROON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN LEE WETZEL PH.D. (SENIOR PROGRAM MANAGER)
(612) 886-2731
Entity
Organization
Contact information
Practice address
1600 E LAKE ST FL 1, MINNEAPOLIS, MN 55407-1884
(612) 889-2731
Mailing address
1600 E LAKE ST FL 1, MINNEAPOLIS, MN 55407-1884
(612) 889-2731
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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