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Individual

ELIJAH WOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DSW, MSW, LICSW

Contact information

Practice address
15265 CARROUSEL WAY STE 100, ROSEMOUNT, MN 55068-1760
(952) 443-4600
Mailing address
15265 CARROUSEL WAY STE 100, ROSEMOUNT, MN 55068-1760

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
28914
MN

Other

Enumeration date
03/21/2023
Last updated
03/28/2023
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