Individual
JOHN R STILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
2809 WAYZATA BLVD, MINNEAPOLIS, MN 55405-2131
(612) 377-9190
(612) 374-4498
Mailing address
2809 WAYZATA BLVD, MINNEAPOLIS, MN 55405-2131
(612) 377-9190
(612) 374-4498
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12770
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467821400
—
MN
Enumeration date
06/14/2006
Last updated
08/28/2008
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