Individual
KATIE BETH BOECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMFT, LSW
Contact information
Practice address
1406 6TH AVENUE NORTH, ST. CLOUD HOSPITAL, ST. CLOUD, MN 56303
(320) 251-2700
(320) 229-5109
Mailing address
1900 CENTRA CARE CLINIC #2475, CENTRA CARE HEALTH PLAZA, SAINT CLOUD, MN 56303
(320) 229-5199
(320) 229-5109
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
16238
MN
1041C0700X
Clinical Social Worker
16238
MN
106H00000X
Marriage & Family Therapist
Primary
2196
MN
Other
Enumeration date
11/15/2010
Last updated
11/18/2011
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