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Individual

JULIE LYNN GAGNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
450 SYNDICATE ST N, SUITE 5, SAINT PAUL, MN 55104-4107
(651) 603-5823
(651) 603-5990
Mailing address
2828 CONDIT ST, SAINT PAUL, MN 55117-1058
(651) 603-5823

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16108
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
66611730
MN
Enumeration date
12/12/2006
Last updated
07/09/2007
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