Individual
MAREN MITTAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1675 VILLAGE TRL E UNIT 6, MAPLEWOOD, MN 55109-5820
(612) 440-7771
Mailing address
1675 VILLAGE TRL E UNIT 6, MAPLEWOOD, MN 55109-5820
(612) 440-7771
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21529
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B712054186310
DRIVERS LICENSE
MN
Enumeration date
08/04/2018
Last updated
11/15/2024
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