Individual
JAN L WEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW LICSW
Contact information
Practice address
10800 LYNDALE AVE S STE 179, BLOOMINGTON, MN 55420-5687
(952) 380-8515
(952) 314-1356
Mailing address
10800 LYNDALE AVE S STE 179, BLOOMINGTON, MN 55420-5687
(952) 380-8515
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12164
MN
Other
Enumeration date
06/02/2006
Last updated
08/02/2010
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