Individual
AMANDA LYNN KUBISTA OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
800 WEST AVE S, LA CROSSE, WI 54601-8806
(608) 785-0940
Mailing address
PO BOX 860912, MINNEAPOLIS, MN 55486-0912
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9421-123
WI
Other
Enumeration date
10/31/2024
Last updated
11/26/2024
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