Individual
MADELINE ANNE SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3400 W 66TH ST STE 400, EDINA, MN 55435-2134
(612) 672-6999
Mailing address
6725 4TH AVE S, RICHFIELD, MN 55423-2423
(650) 224-2536
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
28606
MN
1041C0700X
Clinical Social Worker
Primary
28606
MN
Other
Enumeration date
01/27/2022
Last updated
05/24/2023
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