Individual
MARK ZACZKOWSKI MOORHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
2400 BLAISDELL AVE, MINNEAPOLIS, MN 55404
(612) 444-6090
Mailing address
2400 BLAISDELL AVE, MINNEAPOLIS, MN 55404-3331
(612) 444-6090
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
22176
MN
Other
Enumeration date
06/09/2015
Last updated
11/20/2019
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