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Individual

JESSICA MAE MATHWIG-OLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
1100 GLENWOOD AVE, MINNEAPOLIS, MN 55405-1430
(612) 871-1454
Mailing address
1100 GLENWOOD AVE, MINNEAPOLIS, MN 55405-1430
(612) 871-1454

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17292
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
355452000
MN
01
456G7MA
BCBS
MN
01
822524000
MAGELLEN
MN
01
HP56139
HEALTH PARTNERS
MN
Enumeration date
10/18/2006
Last updated
05/02/2023
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