Individual
KARIN M NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2649 PARK AVE, MINNEAPOLIS, MN 55407-1006
(612) 676-1604
(612) 379-8235
Mailing address
7066 STILLWATER BLVD N, OAKDALE, MN 55128-3937
(651) 777-5222
(651) 251-5205
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20503
MN
1041C0700X
Clinical Social Worker
816
CO
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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