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Individual

CANDICE KAE MOHAMMAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
490 FAIRMONT ST NE, NO BUSINESS, FRIDLEY, MN 55432-1667
(763) 717-7979
Mailing address
490 FAIRMONT ST NE, FRIDLEY, MN 55432-1667
(763) 717-7979

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10756
MN

Other

Enumeration date
07/09/2008
Last updated
07/09/2008
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