Individual
BETHANY LYNNE BUTZOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
525 PORTLAND AVE, MINNEAPOLIS, MN 55415-1533
(612) 388-7699
Mailing address
525 PORTLAND AVE, MINNEAPOLIS, MN 55415-1533
(612) 388-7699
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21983
MN
Other
Enumeration date
06/29/2015
Last updated
06/29/2015
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