Individual
MRS. CAROLE A STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5275 EDINA INDUSTRIAL BLVD, #124, EDINA, MN 55439-2918
(952) 835-7130
(952) 831-1783
Mailing address
5275 EDINA INDUSTRIAL BLVD, #124, EDINA, MN 55439-2918
(952) 835-7130
(952) 831-1783
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LICSW 000169
MN
Other
Enumeration date
03/28/2007
Last updated
07/09/2007
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