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Individual

LOUISE J BLISSENBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
124 ELTON HILLS LN NW, ROCHESTER, MN 55901-3567
(507) 282-1009
Mailing address
407 PROSPECT ST SE, CHATFIELD, MN 55923-1412
(507) 867-4056

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1245
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00468620
MN
Enumeration date
07/12/2006
Last updated
07/08/2007
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