Individual
MR. JEREMY LEE MAURSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, MSSA
Contact information
Practice address
4801 8TH ST N, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
4801 8TH ST N, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16107
MN
Other
Enumeration date
05/16/2006
Last updated
07/12/2007
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