Individual
CARLIE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LGSW
Contact information
Practice address
3550 LEXINGTON AVE N, SHOREVIEW, MN 55126-8075
(612) 516-5044
Mailing address
3550 LEXINGTON AVE N, SHOREVIEW, MN 55126-8075
(612) 516-5044
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
24842
MN
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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