Individual
KATIE ANNE MARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
7975 STONE CREEK DR STE 130, CHANHASSEN, MN 55317-4728
(952) 544-6806
Mailing address
16075 BOULDER CREEK DR, MINNETONKA, MN 55345-6413
(763) 232-6788
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19335
MN
Other
Enumeration date
04/15/2020
Last updated
04/15/2020
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