Individual
LAUREN ANDREA MACCOUX KIZAUR
Active
Individual
LAUREN ANDREA MACCOUX KIZAUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
25455
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25455
BOARD OF SOCIAL WORK
MN
Enumeration date
03/27/2019
Last updated
11/27/2023
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