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Organization

I AM INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEONNE M. WIDNER LICSW (CFO)
(218) 214-9389
Entity
Organization

Contact information

Practice address
19781 MISSION ROAD SE, CASS LAKE, MN 56633
(218) 214-9389
(218) 517-2034
Mailing address
403 4TH ST NW STE 115, BEMIDJI, MN 56601-3155
(218) 214-9389
(218) 517-2034

Taxonomy

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

Other

Enumeration date
08/03/2021
Last updated
07/23/2025
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