Individual
JENNIFER CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3819 LAVERNE AVE N, LAKE ELMO, MN 55042-9629
(612) 242-6115
Mailing address
3819 LAVERNE AVE N, LAKE ELMO, MN 55042-9629
(612) 242-6115
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21481
MN
Other
Enumeration date
06/01/2021
Last updated
07/08/2021
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