Individual
JOANNA WALLENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
514 BELTRAMI AVE NW, BEMIDJI, MN 56601-3010
(218) 444-2845
(218) 444-2847
Mailing address
31795 COUNTY HIGHWAY 50, PARK RAPIDS, MN 56470-4075
(218) 444-2845
(218) 444-2847
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20629
MN
Other
Enumeration date
03/20/2014
Last updated
03/20/2014
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