Individual
MEGAN MANSAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW, LADC
Contact information
Practice address
1741 15TH ST NW, BEMIDJI, MN 56601-8755
(218) 751-6553
(218) 751-1846
Mailing address
45568 US 71, LAPORTE, MN 56461
(651) 408-2574
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24318
MN
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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