Individual
KENZIE JANSON-WOLLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, AASW
Contact information
Practice address
9245 QUANTRELLE AVE NE, OTSEGO, MN 55330-0168
(763) 746-9492
Mailing address
9245 QUANTRELLE AVE NE, OTSEGO, MN 55330-0168
(763) 746-9492
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
28710
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/27/2015
Last updated
09/22/2022
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