Individual
MR. CARL PETER SPORER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1919 UNIVERSITY AVE W STE 6, SAINT PAUL, MN 55104-3453
(651) 641-1555
Mailing address
6901 W 84TH ST APT 363, BLOOMINGTON, MN 55438-3107
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
05957
MN
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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