Individual
MS. KATHLEEN FIELD-TABAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2030 RAHN WAY, EAGAN, MN 55122-2300
(651) 529-1969
(612) 728-5301
Mailing address
17545 KODIAK AVE, LAKEVILLE, MN 55044-9285
(952) 913-5698
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19218
MN
Other
Enumeration date
12/12/2010
Last updated
09/01/2023
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