Individual
KA LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
(651) 280-2310
(651) 280-3995
Mailing address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
(651) 280-2310
(651) 280-3995
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21203
MN
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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