Individual
DONNA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1711 COUNTY ROAD B W, ROSEWOOD OFFICE PLAZA SUITE 210S, ROSEVILLE, MN 55113-4057
(651) 621-2495
(651) 621-2496
Mailing address
1711 COUNTY ROAD B W, ROSEWOOD OFFICE PLAZA SUITE 210S, ROSEVILLE, MN 55113-4057
(651) 621-2495
(651) 621-2496
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1288
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G034AN
BC-BS
MN
01
—
106222
UC
MN
01
—
62-20080
UBH
MN
05
—
658755100
—
MN
01
—
990990570030
PREFERRED ONE
MN
Enumeration date
07/18/2006
Last updated
11/08/2011
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