Individual
DIANE DOCKENDORF OPATZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3333 W DIVISION ST, SAINT CLOUD, MN 56301-4515
(320) 309-8789
Mailing address
823 ALDON DR, SAINT CLOUD, MN 56301-5957
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1902
MN
Other
Enumeration date
03/16/2007
Last updated
05/09/2012
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