Individual
CASSANDRA LEE KOTNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
624 13TH ST S, VIRGINIA, MN 55792-3149
(218) 749-2881
(218) 749-3806
Mailing address
PO BOX 1188, VIRGINIA, MN 55792-1188
(218) 749-2881
(218) 749-3806
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19965
MN
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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