Individual
KATHRYN JANE FAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
522 BELTRAMI AVE NW STE 17, BEMIDJI, MN 56601-3182
(218) 441-3631
Mailing address
522 BELTRAMI AVE NW STE 17, BEMIDJI, MN 56601-3182
(218) 441-3632
(218) 444-0706
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3151
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082722300
—
MN
01
—
11N51GA
BCBS OF MN
MN
01
—
6271239
MEDICA/UBH
MN
Enumeration date
08/07/2006
Last updated
04/17/2024
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