Individual
MRS. CALLIE SUE DEVRIENDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
102 W 1ST ST, DULUTH, MN 55802-2006
(218) 722-7431
(218) 722-0850
Mailing address
102 W 1ST ST, DULUTH, MN 55802-2006
(218) 722-7431
(218) 722-0850
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20402
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20402
STATE LICENSE NUMBER
MN
Enumeration date
02/05/2013
Last updated
02/05/2014
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