Individual
VICTORIA IRWIN KOHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
821 RAYMOND AVE, SUITE 240, SAINT PAUL, MN 55114-1503
(651) 789-0489
(651) 304-1400
Mailing address
821 RAYMOND AVE, SUITE 240, SAINT PAUL, MN 55114-1503
(651) 789-0489
(651) 304-1400
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14394
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
446397800
—
MN
01
—
800001997
MEDICARE PTAN
MN
Enumeration date
09/20/2006
Last updated
01/05/2016
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