Individual
KIEL B WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.S.C.W.
Contact information
Practice address
5200 WILLSON RD, 210, EDINA, MN 55424-1332
(612) 787-2475
Mailing address
5200 WILLSON RD, 210, EDINA, MN 55424-1332
(612) 787-2475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20214
MN
Other
Enumeration date
11/28/2012
Last updated
03/03/2016
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