Individual
MS. DEIRDRE MCKIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
4748 CHICAGO AVE STE 1, MINNEAPOLIS, MN 55407
(612) 821-1920
(612) 821-1919
Mailing address
4748 CHICAGO AVE STE 1, MINNEAPOLIS, MN 55407-4311
(612) 821-1920
(612) 821-1919
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15301
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806980800
—
MN
Enumeration date
11/01/2006
Last updated
08/06/2018
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