Individual
GEORGE HENRY HERZOG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
325 N 33RD AVE, 103, ST CLOUD, MN 56303
(320) 253-3715
(320) 252-2567
Mailing address
325 N 33RD AVE, 103, ST CLOUD, MN 56303
(320) 253-3715
(320) 252-2567
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
00756
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
861554300
—
MN
Enumeration date
09/27/2006
Last updated
10/20/2008
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